Tracheal Atresia/Agenesis Syndrome and a Protocol for Perinatal Management Associated with Indications of Oesophageal Intubation for Oxygenation and Ventilation

Background: Tracheal atresia/agenesis syndrome (TAAS) is an infrequent congenital disorder consisting of tracheal atresia/agenesis that is usually associated with other anomalies. It may be confronted as a challenging emergency for airway management and diagnosis. The mortality rate is high due to associated congenital anomalies and unfamiliarity with surgical procedures for tracheal reconstruction. Outcomes may be improved by proper airway management protocols and plans for multidisciplinary perinatal care. Case presentation: We present the case of a neonate with severe respiratory distress, non-audible cry, and inability to pass an endotracheal tube via the vocal cords. Bag-mask ventilation was possible, and inadvertent oesophageal intubation provided oxygenation and stabilization. Conclusion: TAAS may not be as rare as previously described, and it is amenable to tracheal reconstruction. Increased awareness and a clear initial indication for intentional rather than inadvertent oesophageal intubation for oxygenation may be lifesaving. A proper protocol for early diagnosis and perinatal management may facilitate surgical correction.