Concurrent congenital right-sided diaphragmatic hernia and oesophageal atresia with trachea-oesophageal fistula

This case report presents a rare case of right-sided congenital diaphragmatic hernia (CDH) with concurrent oesophageal atresia and tracheo-oesophageal fistula (OA/TOF) in a premature baby of 32 weeks’ gestation. CDH was diagnosed antenatally and OA/TOF discovered within the first hours of life. We summarise the immediate postnatal and surgical care highlighting the difficult surgical decision making in such cases.

Dr Emile Crouzen
Resident medical officer, paediatrics
emile.crouzen@hbdhb.govt.nz

Mr Edward Hannon
Consultant paediatric surgery

Dr Lawrence Miall
Consultant neonatologist

Leeds Children’s Hospital, Leeds Teaching Hospitals NHS Foundation Trust

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Keywords

congenital diaphragmatic hernia; oesophageal atresia; trachea-oesophageal fistula; premature birth; surgery; high frequency oscillation ventilation

Key points

Respiratory insufficiency is a major factor in mortality rate of congenital diaphragmatic hernia.
Oesophageal atresia has a better outcome than isolated CDH with respiratory insufficiency.
The combination of congenital diaphragmatic hernia and oesophageal atresia and tracheo-oesophageal fistula and associated morbidity of both diagnoses results in very poor survival.

Also published in Infant:

VOLUME 14/ISSUE 2, MARCH 2018

Nursing the surgical neonate part 2: how can we deliver best practice now and in the future?

This article describes the development of a work-based, university accredited, clinical module for registered nurses caring for neonates requiring surgery for gastrointestinal or urogenital conditions: Nursing the Surgical Neonate: Gastrointestinal and Urogenital Disorders. This specialist, part-time course has been developed as part of the Birmingham Children’s Hospital Neonatal Surgical Outreach Service, commissioned in response to specific local issues in the West Midlands. The relevance of the course is discussed in context with the need for a future workforce with specialist knowledge and skills to influence outcomes for some of the most vulnerable patients in our healthcare system.