Endoscopic treatment of tracheal diverticulum after primary repair of esophageal atresia and tracheoesophageal fistula.

Two cases of recurrent and persistent respiratory symptoms after primary repair of esophageal atresia and tracheoesophageal fistula are described. The diagnostic workup included barium swallow examination, radionuclide study for gastroesophageal reflux, and bronchoscopy. The tracheal diverticulum was detected on bronchoscopy. Treatment consisted of endoscopic cauterization of the mucosa of the diverticulum and its orifice using electrocoagulation in case 1 and the Nd:YAG laser in case 2. Electrocoagulation produced tracheal edema, which caused severe respiratory distress necessitating temporary tracheostomy. Cauterization with the Nd:YAG laser was safe, effective, and uncomplicated.