The 'pitfalls' of intubation: airway complications following tracheo-oesophageal fistula repair

A 6-month-old girl, born at 34 weeks gestation, with a history of VACTERL, thoracoscopic repair of a tracheo-oesophageal fistula and oesophageal atresia was referred with a new oxygen requirement. She was admitted for further investigations, including bronchoscopy with bronchoalveolar lavage and oesophageal dilatation. Flexible bronchoscopy demonstrated a deep blind-ending pit with associated tracheomalacia and distorted bronchial anatomy (figure 1). Figure 1 Flexible bronchoscopy (2.8 mm scope) performed via laryngeal-mask airway. The larynx appeared normal with swollen and inflamed arytaenoids. Vocal cord movements …