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Case Report
Early ligation of the gastroesophageal junction to manage respiratory instability in tracheal agenesis: A case report
1 Department of General Surgery, Division of Pediatric Surgery, Loma Linda University School of Medicine, Loma Linda, CA, USA
2 Department of General Surgery, Division of Pediatric Surgery, Loma Linda University Health, Loma Linda, CA, USA
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Ali Mejaddam
11234 Anderson St, Loma Linda, CA 92354, USA,
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Article ID: 100159Z12JA2025
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How to cite this article
Amann J, McRae JJLH, Kashtan M, Radulescu A, Mejaddam A. Early ligation of the gastroesophageal junction to manage respiratory instability in tracheal agenesis: A case report. J Case Rep Images Surg 2025;11(2):5–9.ABSTRACT
Introduction: Tracheal agenesis (TA) is an exceedingly rare life-threatening congenital malformation. It can present in isolation, as part of congenital syndromes, or in the setting of chromosomal abnormalities and is associated with recognized risk factors such as maternal diabetes. An associated tracheoesophageal fistula (TEF) can allow for ventilation at birth via the esophagus. However, mortality among patients with TA remains high, even with prompt surgical intervention.
Case Report: We present the case of a male infant who had delayed diagnosis of TA. The patient underwent emergent exploratory laparotomy and ligation of the gastroesophageal junction to temporize his respiratory instability but ultimately was transitioned to comfort focused care following multidisciplinary discussion with his family.
Conclusion: This case highlights the importance of early recognition of TA. Temporizing measures, including surgical ligation of the gastroesophageal junction, can allow time for more definitive treatments.
Keywords: Gastroesophageal ligation, Pediatric surgery, Tracheal agenesis
SUPPORTING INFORMATION
Author Contributions
Jacob Amann - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Joyce JLH McRae - Substantial contributions to conception and design, Analysis of data, Drafting the article, Final approval of the version to be published
Mark Kashtan - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Andrei Radulescu - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Ali Mejaddam - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Jacob Amann et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
