Novel use of glycopyrrolate (Robinul) in the treatment of anastomotic leak after repair of esophageal atresia and tracheoesophageal fistula

J Pediatr Surg. 2011 Mar;46(3):e29-32. doi: 10.1016/j.jpedsurg.2010.11.040.


Anastomotic leak after tracheoesophageal fistula repair is a well-known complication and can represent a challenging clinical scenario. We present the case of an infant girl with VACTERL syndrome who underwent repair of a type C esophageal atresia and tracheoesophageal fistula repair, which was complicated by an anastomotic leak. Glycopyrrolate (Robinul), an anticholinergic agent, was successfully used to decrease copious salivary secretion and promote spontaneous closure of the leak. This report represents the first description in the medical literature of the use of glycopyrrolate in the treatment of an esophageal anastomotic leak. Glycopyrrolate may be a useful adjunct in the management of anastomotic leak after tracheoesophageal repair.

Publication types

  • Case Reports

MeSH terms

  • Anal Canal / abnormalities
  • Anastomotic Leak / surgery*
  • Chest Tubes*
  • Colostomy
  • Esophageal Atresia / diagnostic imaging
  • Esophageal Atresia / surgery*
  • Esophagoplasty*
  • Esophagus / abnormalities
  • Female
  • Glycopyrrolate / pharmacology
  • Glycopyrrolate / therapeutic use*
  • Heart Defects, Congenital
  • Humans
  • Infant, Newborn
  • Kidney / abnormalities
  • Limb Deformities, Congenital
  • Muscarinic Antagonists / pharmacology
  • Muscarinic Antagonists / therapeutic use*
  • Postoperative Care
  • Radiography
  • Salivation / drug effects*
  • Spine / abnormalities
  • Thoracostomy
  • Trachea / abnormalities
  • Tracheoesophageal Fistula / diagnostic imaging
  • Tracheoesophageal Fistula / surgery*


  • Muscarinic Antagonists
  • Glycopyrrolate

Supplementary concepts

  • VACTERL association