Contributor: Deepak Mehta (Children’s Hospital of Pittsburgh)
Endoscopic Repair of Tracheal-bronchial Sinus Tract: Clinical History: 6 year-old female with a history of tracheal-esophageal fistula s/p repair at birth and a right sided aortic arch. She has a recent history of 6 episodes of pneumonia requiring hospitalization. She had a normal modified barium swallow exam. CT chest revealed a tract arising from the posterior carina. Operative Course: The patient was taken to the OR and using a 5.0 rigid ventilating bronchoscope we are able to easily visualize the tracheal bronchial sinus tract originating from the posterior carina. A flexible suction catheter was used to probe the tract. It extended approximately 1.5cm. Then using a Urologic Bugbee electrocautery, we de- epithelialized the tract. Next, Tisseel fibrin sealant was injected into the tract, closing it off. The bronchoscope was removed and the patient was admitted overnight for observation. She did well with no desaturations or complications and was discharged home on post op day #1.