Anastomotic leak after tracheoesophageal fistula repair is a well-known complication and can represent a challenging clinical scenario. We present the case of an infant girl with VACTERL syndrome who underwent repair of a type C esophageal atresia and tracheoesophageal fistula repair, which was complicated by an anastomotic leak. Glycopyrrolate (Robinul), an anticholinergic agent, was successfully used to decrease copious salivary secretion and promote spontaneous closure of the leak. This report represents the first description in the medical literature of the use of glycopyrrolate in the treatment of an esophageal anastomotic leak. Glycopyrrolate may be a useful adjunct in the management of anastomotic leak after tracheoesophageal repair.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Pediatric Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Esophageal atresia with obstructed tracheoesophageal fistula and gasless abdomen.J Pediatr Surg. 1991; 26: 160-162
- Prediction and prevention of anastomotic complications of esophageal atresia and tracheoesophageal fistula.J Pediatr Surg. 1990; 25: 778-781
- Transpleural repair of esophageal atresia without a primary gastrostomy: 240 patients treated between 1951 and 1983.J Pediatr Surg. 1985; 20: 823-828
- Anastomotic leakage following surgery for esophageal atresia.J Pediatr Surg. 1992; 27: 29-32
- Management of esophageal atresia: review of 16 years' experience.J Pediatr Surg. 1988; 23: 805-809
- Prognosis of congenital tracheoesophageal fistula with esophageal atresia on the basis of gap length.Pediatr Surg Int. 2007; 23: 767-771
- Major anastomotic dehiscence after repair of esophageal atresia: conservative management or reoperation?.Dis Esophagus. 2005; 18: 120-123
- Glycopyrrolate: pharmacology and clinical use.Anaesthesia. 1983; 38: 1195-1204
- Use of glycopyrrolate and other anticholinergic medications for sialorrhea in children with cerebral palsy.Clin Pediatr. 1998; 37: 485-490
- Treatment of sialorrhea with glycopyrrolate. A double-blind, dose-ranging study.Arch Pediatr Adolesc Med. 2000; 154: 1214-1218
- Management of secretions in esophageal cancer patients with glycopyrrolate.Ann Oncol. 1997; 8: 198-199
- Oral glycopyrrolate alleviates drooling in a patient with tongue cancer.J Pain Symptom Manage. 1999; 18: 300-302
- Endoscopic clip application as an adjunct to closure of mature esophageal perforation with fistulae.Clin Gastroenterol Hepatol. 2003; 1: 44-50
Accepted: November 19, 2010
Received in revised form: November 15, 2010
Received: September 15, 2010
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.