An occult tracheal pouch causing life-threatening endotracheal tube displacements in an infant after repair of esophageal atresia with tracheoesophageal fistula

Tracheal pouches can cause dangerous respiratory problems. This case concerns an occult tracheal pouch in a child, occurring after neonatal repair of esophageal atresia with tracheoesophageal fistula. The pouch caused life-threatening displacements of endotracheal tubes, both during and after intubations. In addition to the tracheal pouch, the child had recurrence of an upper esophageal fistula and severe tracheomalacia which complicated the acute respiratory symptoms. This case reveals possible pitfalls in the care and treatment of patients after esophageal/tracheal surgery. The care and treatment of these children is challenging and may require a multidisciplinary setting and several surgical procedures