title: Life-threatening anoxic spells caused by tracheal compression after repair of esophageal atresia: correction by surgery.
abstract: Three infants who developed anoxic spells 2, 5, and 20 mo following repair of esophageal atresia developed apneic spells during or within a few minutes of feeding. These episodes began with stridor and cyanosis; when severe, they progressed to apnea and loss of consciousness. Mouth-to-mouth resuscitation was often necessary. Investigations failed to detect esophageal obstruction and/or a recurrent tracheoesophageal fistula. No neurologic or cardiac abnormalities were found. The cause was compression of a 1- to 3-cm segment of trachea anteriorly by a vascular structure and posteriorly by a dilated esophagus that emptied slowly because of poor motility. Endoscopy confirmed the x-ray findings. The aortic arch and innominate artery were suspended to the sternum anteriorly, which relieved the apneic spells in all patients.
mesh_terms: D001049:Apnea / Q000209:etiology; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000601:surgery; D004933:Esophageal Atresia / Q000601:surgery*; D006801:Humans; D000860:Hypoxia / Q000209:etiology*; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000601:surgery*; D014133:Tracheal Diseases / Q000209:etiology / Q000601:surgery*; D014138:Tracheoesophageal Fistula / Q000601:surgery