Skip to main content
SpringerLink
Log in

Trachealagenesie

Eine seltene Ursache der respiratorischen Insuffizienz des Neugeborenen

Tracheal agenesis

A rare cause of respiratory insufficiency in neonates

  • Kasuistiken
  • Published:
Der Anaesthesist Aims and scope Submit manuscript

Zusammenfassung

Die Trachealagenesie ist eine sehr seltene, isoliert oder in Kombination mit anderen Anomalien auftretende Fehlbildung. Sie präsentiert sich unmittelbar nach der Geburt durch eine akute respiratorische Insuffizienz und fehlendes Schreien. Die präzise anatomische Einordnung der Fehlbildung ist schnellstens erforderlich, um eine mögliche chirurgische Therapieoption beurteilen zu können. Bei unserem Patienten wurde nach wenigen Stunden die Diagnose einer langstreckigen Trachealagenesie-Typ II per Spiralcomputertomographie gesichert; eine Auswahl der Bilder wird präsentiert. Die Behandlung wurde danach wegen fehlender Therapieoptionen abgebrochen. Anhand unserer Kasuistik soll die besondere Problematik dieser seltenen Fehlbildung dargestellt werden. Wissenswertes zur Trachealagenesie wurde zusammengetragen. Die Differenzialdiagnose der respiratorischen Insuffizienz des Neugeborenen wird rekapituliert und ein modifizierter Algorithmus der aktuellen Neugeborenenreanimationsleitlinien der American Heart Association vorgestellt.

Abstract

Tracheal agenesis is a very rare congenital anomaIy that occurs isolated or in combination with other anomalies. It presents immediately after birth with an absolute respiratory insuffiency and lack of crying. The immediate precise anatomical classification of the anomaly is crucial in order to decide if surgical therapy is possible. This report describes a newborn boy with tracheal agenesis type II. The diagnosis was confirmed by spiral computed tomography and a selection of the pictures is presented. The treatment was discontinued due to a lack of therapeutical options. Based on this case report we discuss the special situation of this rare anomaly. Interesting information on tracheal agenesis was gathered, the differential diagnosis of respiratory insufficiency of the newborn is summarised and a modified algorithm of the current newborn resuscitation guidelines of the American Heart Association is presented.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6

Literatur

  1. American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiocascular Care (2005) Part 13: Neonatal resuscitation guidelines. Circulation 112: IV188–195

    Google Scholar 

  2. Biarent D, Bingham R, Richmond S et al. (2005) European Resuscitation Council guidelines for resuscitation 2005. Section 6. Paediatric life support. Resuscitation 67 [Suppl 1]: S97–133

    Article  PubMed  Google Scholar 

  3. Bray RJ, Lamb WH (1988) Tracheal stenosis or agenesis in association with tracheo-oesophageal fistula and oesophageal atresia. Anaesthesia 43: 654–658

    PubMed  Google Scholar 

  4. Bremer JL (1957) Congenital anomalies of the viscera: their embryological basis. Harvard University Press, Cambridge

    Google Scholar 

  5. Buchino JJ, Meagher DP Jr, Cox JA (1982) Tracheal agenesis: a clinical approach. J Pediatr Surg 17: 132–137

    PubMed  Google Scholar 

  6. Crombleholme TM, Sylvester K, Flake AW, Adzick NS (2000) Salvage of a fetus with congenital high airway obstruction syndrome by ex utero intrapartum treatment (EXIT) procedure. Fetal Diagn Ther 15: 280–282

    Article  PubMed  Google Scholar 

  7. Das BB, Nagaraj A, Rao AH, Rajegowda BK (2002) Tracheal agenesis: report of three cases and review of the literature. Am J Perinatol 19: 395–400

    Article  PubMed  Google Scholar 

  8. Effmann EL, Spackman TJ, Berdon WE et al. (1975) Tracheal agenesis. Am J Roentgenol Radium Ther Nucl Med 125: 767–781

    PubMed  Google Scholar 

  9. Floyd J, Campbell DC Jr, Dominy DE (1962) Agenesis of the trachea. Am Rev Respir Dis 86: 557–560

    PubMed  Google Scholar 

  10. Fraser N, Stewart RJ, Grant J et al. (2005) Tracheal agenesis with unique anatomy. J Pediatr Surg 40: e7–10

    Article  Google Scholar 

  11. Gruenwald P (1940) Case of atresia of oesophagus combined with tracheo-esophageal fistula in 9 mm human embryo, and its embryological explanation. Anat Rec 78: 293–302

    Article  Google Scholar 

  12. Kalache KD, Chaoui R, Bollmann R (1997) Doppler assessment of tracheal and nasal fluid flow during fetal breathing movements: preliminary observations. Ultrasound Obstet Gynecol 9: 257–261

    Article  PubMed  Google Scholar 

  13. Kalache KD, Franz M, Chaoui R, Bollmann R (1999) Ultrasound measurements of the diameter of the fetal trachea, larynx and pharynx throughout gestation applicability to prenatal diagnosis of obstructive anomalies of the upper respiratory-digestive tract. Prenat Diagn 19: 211–218

    Article  PubMed  Google Scholar 

  14. Kattwinkel J (2000) Neonatal resuscitation. American Academy of Pediatrics, Elk Grove Village

  15. Kawaguchi AL, Donahoe PK, Ryan DP (2005) Management and long-term follow-up of patients with types III and IV laryngotracheoesophageal clefts. J Pediatr Surg 40: 158–164; discussion 164–155

    Article  PubMed  Google Scholar 

  16. Manschot HJ, Anker JN van den, Tibboel D (1994) Tracheal agenesis. Anaesthesia 49: 788–790

    PubMed  Google Scholar 

  17. Milstein JM, Lau M, Bickers RG (1985) Tracheal agenesis in infants with VATER association. Am J Dis Child 139: 77–80

    PubMed  Google Scholar 

Download references

Interessenkonflikt

Keine Angaben

Author information

Authors and Affiliations

  1. Klinik für Anästhesiologie und Intensivtherapie, FSU, Erlanger Allee 101, 07747, Jena, Deutschland

    W. Schummer DEAA, EDIC & C. Schummer

  2. Klinik für Frauenheilkunde und Geburtshilfe, FSU, Jena, Deutschland

    P. Klemm

  3. Institut für Pathologie, FSU, Jena, Deutschland

    M. Brodhun

  4. Institut für Diagnostische und Interventionelle Radiologie, FSU, Jena, Deutschland

    R. Neumann

  5. Klinik für Kinderchirurgie, FSU, Jena, Deutschland

    M. Bondartschuk

  6. Klinik für Hals-Nasen-Ohren-Krankheiten, FSU, Jena, Deutschland

    S. Koscielny

  7. Klinik für Kinder und Jugendmedizin, FSU, Jena, Deutschland

    A. Hübler

Authors
  1. W. Schummer DEAA, EDIC
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Schummer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Klemm
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Brodhun
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R. Neumann
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Bondartschuk
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. Koscielny
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. Hübler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W. Schummer DEAA, EDIC.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schummer, W., Schummer, C., Klemm, P. et al. Trachealagenesie. Anaesthesist 55, 1259–1265 (2006). https://doi.org/10.1007/s00101-006-1087-3

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00101-006-1087-3

Schlüsselwörter

Keywords

Search

Navigation