Life-threatening anoxic spells caused by tracheal compression after repair of esophageal atresia: correction by surgery

J Pediatr Surg. 1976 Oct;11(5):739-48. doi: 10.1016/0022-3468(76)90098-1.


Three infants who developed anoxic spells 2, 5, and 20 mo following repair of esophageal atresia developed apneic spells during or within a few minutes of feeding. These episodes began with stridor and cyanosis; when severe, they progressed to apnea and loss of consciousness. Mouth-to-mouth resuscitation was often necessary. Investigations failed to detect esophageal obstruction and/or a recurrent tracheoesophageal fistula. No neurologic or cardiac abnormalities were found. The cause was compression of a 1- to 3-cm segment of trachea anteriorly by a vascular structure and posteriorly by a dilated esophagus that emptied slowly because of poor motility. Endoscopy confirmed the x-ray findings. The aortic arch and innominate artery were suspended to the sternum anteriorly, which relieved the apneic spells in all patients.

Publication types

  • Case Reports

MeSH terms

  • Apnea / etiology
  • Child, Preschool
  • Constriction, Pathologic / surgery
  • Esophageal Atresia / surgery*
  • Humans
  • Hypoxia / etiology*
  • Infant
  • Male
  • Postoperative Complications / surgery*
  • Tracheal Diseases / etiology
  • Tracheal Diseases / surgery*
  • Tracheoesophageal Fistula / surgery