Intubation videoendoscopy in a preterm infant with congenital tracheal stenosis and laryngotracheoesophageal cleft: a case report

Background The co-occurrence of congenital laryngotracheoesophageal cleft and tracheal stenosis is extremely rare. Diagnosis is difficult and many affected neonates die within hours to days. Case presentation A male neonate was delivered at 32 weeks and 5 days of gestation. Birth weight was 1364 g. Severe asphyxia and respiratory failure were apparent soon after birth. Endotracheal intubation was not successful and esophageal intubation did not provide effective ventilation. Flexible intubation videoendoscopy was performed immediately while continuing mask bagging, which identified congenital laryngotracheoesophageal cleft and tracheal stenosis. Considering the diagnosis, our inability to intubate, and the patient’s other anomalies including left diaphragmatic hernia and congenital heart disease, palliative care was proposed and the family agreed. He died 4 h after birth. Conclusions Congenital laryngotracheoesophageal cleft and tracheal stenosis, a rare and mostly fatal anomaly, can be diagnosed in neonates using intubation videoendoscopy. Rapid diagnosis allows for the early introduction of palliative care.