Tracheo-oesophageal Fistula with Partial Pulmonary Agenesis, Broncho-oesophageal Fistula, and Gastric Duplication in a Neonate: A Case Report on the Spectrum of Aberrations in Foregut Embryogenesis

An erroneous connection between the trachea and oesophagus is the hallmark of Tracheo-Oesophageal Fistula (TEF), a congenital disorder that can provide serious complications for newborn care. TEF results from a defect in foregut embryogenesis that interferes with the trachea and oesophagus’s natural separation during foetal development. Since, it frequently co-exists with other congenital conditions such as anorectal malformations, cardiac problems or skeletal abnormalities, early identification and interdisciplinary care are essential for the best results. A 36-week-old preterm low birth weight male neonate presented within 12 hours of birth, having respiratory distress, diagnosed as TEF, detected to have a rare combination of multiple congenital anomalies related to foregut development like partial pulmonary agenesis, bronchoesophageal fistula and gastric duplication in a preterm male neonate. The complexity of this presentation required coordinated surgical interventions including thoracotomy, oesophagostomy and excision of a gastric duplication cyst. To the greatest extent of the information, this was the first human case of its sort to be documented in the literature, exhibiting three foregut development abnormalities: gastric duplication, partial pulmonary agenesis and bronchooesophageal fistula. In the present case, the gastric duplication cyst was surgically removed during the TEF repair, highlighting the need of treating all abnormalities thoroughly to get better results. This case highlights the challenges and management strategies in addressing multiple anomalies in neonates with TEF.