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Pediatric Gastroenterology


Answer 2
  1. Surgery to correct the anatomic defects. The patient requires surgery to close the tracheoesophageal fistula and to anastomose the proximal and distal esophagus. If the gap between the esophageal segments is too long, a segment of small or large intestine can be interposed to restore patency. Endoscopic reattachment of the proximal and distal esophagus is not technically possible. An endobronchial stent might help with aspiration but would not allow oral feeding. Total parenteral nutrition would not reduce the risk of aspiration and is suboptimal compared with enteral feeding. A percutaneous endoscopic gastrostomy tube could be considered if the baby was premature or had other complex medical issues, but these factors are absent in this patient and it is best to proceed directly to surgery.

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