Abstract
Tracheal agenesis is a rare lethal congenital anomaly. We describe a neonate with this anomaly who presented with respiratory distress and no audible cry. His lungs were ventilated with an endotracheal tube inserted into the esophagus. He was suspected to have tracheal agenesis. At 3 hours of age, operation was performed, consisting of pseudotracheostomy using esophagus, distal esophageal ligation, cervical esophagostomy for saliva drainage and gastrostomy. After the first operation, it was difficult to maintain adequate ventilation because the esophagus and fistula was used as a part of airway. Application of high PEEP and sedation did not improve his ventilation effectively. So at 52 days of age, he underwent anastomosis of esophagus and trachea with external stenting under cardiopulmonary bypass. After the second operation, his clinical condition became stable, and on postoperative day 34, he was successfully weaned from mechanical ventilation, and discharged from hospital at 10 months of age.
