Endoscopic obliteration of a recurrent tracheoesophageal fistula with enbucrilate and polidocanol in a child.
We present a difficult case of a recurrent tracheoesophageal fistula following primary surgical repair of esophageal atresia. After four unsuccessful attempts to close the fistula, which included three thoracotomies and one endoscopic obliteration using fibrin glue, successful recurrent tracheoesophageal fistula closure was attained with the endoscopic application of enbucrilate (Histoacrylate) combined with polidocanol. Enbucrilate was applied into the lumen of the fistula by bronchoscopy, and polidocanol (Sclerovein) was injected into the esophageal submucosa around the fistula by esophagoscopy. Three years after this treatment, the fistula remains apparently closed.
Lopes
M F
MF
Department of Surgery, Pediatric Hospital of Coimbra - CHC, 3000 Coimbra, Portugal. intcir1@hpc.chc.min-saude.pt
Pires
J
J
Nogueria Brandão
A
A
Reis
A
A
Morais Leitão
L
L
D001999:Bronchoscopy; D004659:Enbucrilate / Q000008:administration & dosage*; D004933:Esophageal Atresia / Q000601:surgery; D004945:Esophagoscopy; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation; D014014:Tissue Adhesives / Q000008:administration & dosage*; D014138:Tracheoesophageal Fistula / Q000209:etiology / Q000601:surgery*
D014014:Tissue Adhesives; D000077423:Polidocanol; D011092:Polyethylene Glycols; D004659:Enbucrilate