“…A newborn with tracheal agenesis presents with immediate respiratory distress and an absent or very weak cry. Our case is compatible with type II TA, the most common abnormality (65%), followed by type III (22%) and type I (13%) [7].…”
These findings were further confirmed by direct laryngoscopic visualization in the operating room (Video). No surgical intervention was done due to the unstable and critical condition of the patient. Two days later, patient developed cardio respiratory arrest and was declared dead.
“…A newborn with tracheal agenesis presents with immediate respiratory distress and an absent or very weak cry. Our case is compatible with type II TA, the most common abnormality (65%), followed by type III (22%) and type I (13%) [7].…”
These findings were further confirmed by direct laryngoscopic visualization in the operating room (Video). No surgical intervention was done due to the unstable and critical condition of the patient. Two days later, patient developed cardio respiratory arrest and was declared dead.
“…Forty-nine cases of TA, including our case, were found [1, 2, 4–7, 9–11, 14, 17, 18, 20, 23, 24, 26, 29–33, 35–38, 40, 42]. The perinatal characteristics, diagnostic investigations, and management are summarized (Table 1) .…”
Tracheal agenesis (TA) is a severe congenital disorder with often an unexpected emergency presentation. There is complete or partial absence of the trachea below the larynx, with presence or absence of a tracheoesophageal fistula (TOF). A neonate with TA is described, and another 48 cases found in literature are reviewed. Due to absence of a TOF, five cases were diagnosed prenatally because of congenital high airway obstruction syndrome (CHAOS). When a TOF is present, polyhydramnion and several other congenital malformations seen on the ultrasound examination should alert clinicians of potential tracheal problems. Prenatal magnetic resonance imaging (MRI) may provide a definitive diagnosis. Postnatal diagnosis is based on recognition of specific clinical signs in the newborn with TA: respiratory distress with breathing movement without appropriate air entry, no audible cry, and failed endotracheal intubation. Despite progress in surgical interventions, mortality remains high. Prenatal diagnosis of TA is possible, but only if a TOF is absent resulting in CHAOS. Prenatal diagnosis of polyhydramnion and other congenital malformation should alert clinicians of potential tracheal problems. Prenatal MRI may provide a definitive diagnosis.
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