Type C tracheoesophageal fistula, ventricular septal defect, and megacolon in a 37-week fetus - A case report

37周胎儿合并C型气管食管瘘、室间隔缺损和巨结肠——病例报告

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Abstract

BACKGROUND: Congenital anomalies affecting multiple organ systems require thorough anatomical documentation to advance our understanding of developmental variations and guide clinical management strategies. The objective was to document comprehensive anatomical findings in a 37-week female fetus with multiple congenital anomalies, emphasizing the importance of thorough evaluation. CASE PRESENTATION: Comprehensive cadaveric dissection was performed on a preserved 37-week female fetus with antenatal history of congenital abnormalities. Dissection revealed three significant anomalies: Type C tracheoesophageal fistula with proximal esophageal atresia, a 3 mm muscular ventricular septal defect, and significant colonic dilation. The anus was patent with normal external appearance. Radiological examination showed normal vertebral alignment. The urinary system and limbs demonstrated no apparent malformations. DISCUSSION: This case presents the co-occurrence of three significant congenital anomalies affecting different embryological developmental windows. The temporal overlap of organogenesis during weeks 4-8 of gestation explains the potential for multiple system involvement. Clinical implications include the need for immediate neonatal surgical intervention, long-term multidisciplinary care, and comprehensive family counselling regarding prognosis and management. CONCLUSIONS: This case demonstrates the importance of comprehensive anatomical evaluation in fetuses with congenital anomalies and provides specific insights for clinical management. The findings support current understanding of developmental field defects and emphasize the need for standardized evaluation protocols in similar cases. Future research should focus on genetic analysis, long-term outcome studies, and development of evidence-based management guidelines for complex multi-organ anomalies.

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