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  • Successful management of anastomotic leakage with endoscopic fibrin glue injection after primary repair of pure oesophageal atresia

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Case report
Successful management of anastomotic leakage with endoscopic fibrin glue injection after primary repair of pure oesophageal atresia
  1. Chloe Roy1,
  2. Ryo Tamura1,
  3. Leigh McDonald2 and
  4. Hany Gabra1
  1. 1Paediatric Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  2. 2Radiology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  1. Correspondence to Ryo Tamura; nmy.tamura{at}gmail.com

Abstract

Anastomotic leakage (AL) occurs in 15% of cases of primary repair of oesophageal atresia. Urgent surgery is indicated in cases of complete anastomotic separation or severe mediastinitis. Otherwise, conservative management including keeping the patient nil per os (NPO), feeding via transanastomotic tube and prolonged parenteral nutrition, has been widely accepted as it can avoid multiple surgeries in neonates and allow oesophageal continuity to be preserved. However, complications relating to prolonged feeding tube use are common downsides to this approach and the negative impact of prolonged NPO on mastication and swallowing function cannot be ignored.

In this case report, a novel approach for the treatment of AL with fibrin glue is reported, following primary repair of oesophageal atresia. It was endoscopically injected into the leakage site to enhance healing and early closure. This procedure was safely performed and achieved early establishment of oral feeding.

  • neonatal and paediatric intensive care
  • paediatric surgery
  • endoscopy
  • interventional radiology

https://doi.org/10.1136/bcr-2020-238823

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    Footnotes

    • Twitter @LGMcDonald1

    • Contributors CR and RT contributed equally to all of works in this paper for designing, analysing and writing. LM and GH supervised the writing of the article by CT and RT and was mainly involved in the statement in the discussion.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Parental/guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.