Tracheal agenesis: A clinical approach

Tracheal agenesis, though seemingly rare and fatal to date, has been reported from multiple institutions with increasing frequency. Establishment of the diagnosis necessitates a high index of suspicion in an infant in respiratory distress at birth, without a cry and in whom intubation is difficult. Following definitive diagnosis by endoscopy, infants have been given a chance at survival on four occasions by prompt surgical intervention. The procedure proposed by Altman is adequate for initial stabilization. Postoperative management is aided by the use of continuous positive airway pressure (CPAP) and rigorous pulmonary toilet. Definitive correction should be considered at an early stage in order to prevent fatal complications.