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

Lookup NU author(s): Dr Leigh McDonald, Hany GabraORCiD

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Abstract

© 2021 BMJ Publishing Group. All rights reserved.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.

Publication metadata

Author(s): Roy C, Tamura R, McDonald L, Gabra H

Publication type: Article

Publication status: Published

Journal: BMJ Case Reports

Year: 2021

Volume: 14

Issue: 1

Online publication date: 28/01/2021

Acceptance date: 15/01/2021

ISSN (electronic): 1757-790X

Publisher: BMJ Publishing Group

URL: http://dx.doi.org/10.1136/bcr-2020-238823

DOI: 10.1136/bcr-2020-238823

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