Abstract
We report the case of a pediatric patient with isolated esophageal atresia (EA) and foregut-derived cysts (FCs). At 24 weeks of gestation, sonographic examination revealed EA and an intrathoracic cyst. The male baby weighing 1,726 g was born at 36 weeks of gestation and was diagnosed as having EA associated with a mediastinal cyst. During his early postnatal life, he developed transient respiratory impairment. After 20 attempts of mechanical bougienage of both the upper and lower esophageal pouches, he underwent cystectomy and esophagoesophagostomy concomitantly at 192 days of age. Histopathological examination revealed the cyst wall to be lined with ciliated columnar and squamous epithelial cells, confirming the diagnosis of FC. In most neonates with isolated EA, end-to-end esophagoesophagostomy requires time for completion because of the long distance between the upper and lower esophageal segments. FC commonly occurs in the posterior mediastinum, and occasional cyst enlargement causes respiratory dysfunction and negatively impacts the standard therapeutic strategy for EA. During the stand-by for concomitant surgery for EA and FC, we should simulate emergent respiratory depression and formulate a strategy beforehand to cope with it.
