Esophageal Atresia Repair in a Premature Infant Complicated By Anastomotic Leak and Stricture: A Case Report
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Esophageal atresia (EA) is a rare congenital malformation commonly associated with tracheoesophageal fistula (TEF). Surgical repair in premature infants remains challenging due to fragile tissues and high postoperative complication risks, as highlighted in recent analyses (1, 2).
We report the case of a premature female infant born at 34 weeks’ gestation weighing 1.8 kg, diagnosed with Gross type III EA. Primary end-to-end esophagoesophageal anastomosis with distal TEF ligation was performed under moderate tension. On postoperative day 7, an anastomotic leak occurred, which closed spontaneously by day 17. At one month, an anastomotic stricture developed and was successfully treated with five sessions of endoscopic balloon dilatation. The infant showed favorable growth, with a weight of 6.3 kg at six months, full oral feeding, and a normal barium swallow without residual stenosis.
This case highlights the feasibility of conservative management for postoperative complications following EA repair, even in premature infants. Early recognition and endoscopic follow-up are essential to ensure optimal healing and long-term functional outcomes (3, 4, 5).
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Copyright (c) 2025 Karima Lalaoui, Mohamed Djelad, Assia Haif, Boubaker Bendecheche
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