THE THORACIC MISHAP OF TEF WITH CDH: A CASE REPORT

Background: Coexistence of tracheo-osophageal fistula with congenital diaphragmatic hernia is very rare. There are only 36 reported cases till date and no specific consensus established regarding management. But working on their combined pathophysiology meticulously; peri-operative, anaesthetic and surgical challenges in management of the duo can be tackled with available resources. We present case of full Case Presentation: term, small for gestational age neonate with birth weight of 2.100 kg having type C Tracheo-osophageal fistula and left Bochdalek type congenital diaphragmatic hernia with persistent pulmonary hypertension. Baby was managed in neonatal intensive care unit with intravenous sildenafil and high frequency oscillatory ventilator. Baby was operated on day 2 for repair of diaphragmatic hernia with left tube thoracostomy and gastroesophageal junction ligation, feeding gastrostomy, prosthetic patch abdominoplasty and left cervical esophagostomy. On post Op day 2, baby's condition deteriorated and could not be revived. Though there are less reported cases and lacking sp Conclusion: ecific protocols for management of 'tracheo-osophageal fistula with congenital diaphragmatic hernia', treatment can be individualized considering patient's condition and available medical services.