It has to be treated surgically.

Anastomotic leaks are seen in operated cases of tracheo-esophageal fistula, operated cases which can be managed conservatively and rarely require a second operation.

If a baby has worsening of respiratory distress post-operatively with an increase in respiratory distress, anastomotic leak must be strongly considered and managed.

All the tracheo-esophageal fistula operated cases must be evaluated with esophagram at end of first week for any anastomotic leak as missing the leak would be disastrous to the neonate.

Anastomotic leak which is usually seen in around 15% cases. In the presence of leak, feeding is withheld and the patient continued on TPN, broad-spectrum antibiotics and the majority of the times the leak gets spontaneously closed without a second operation.

Thank you Hussein faour sir for valuable answer.

Agreed with Dr Hussein

With

As with any fistula management, provided no significant acute respiratory compromise, delineate anatomy, treat sepsis, deal with nutrition.

The management is a truly multi disciplinary decision with combined GI and thoracics, dietetics, radiology, enDoscopy etc.

Surgery is likely, DiSCoNNEcT FisTuLA, conSiDER Flap To AiRWAY Eg INTERSCoStal MUSCLe, WHat To Do With ThE CoNDUIT DEpEnDS ON ITS BLOOd SUPpLY / VIAbILItY / SiZEAnd SiTE OF LEAK.