Congenital Lesions of the Thorax in Infancy Demanding Early Surgical Treatment

Respiratory distress in the young infant is a common occurrence. Approximately one-half of the fatalities in the newborn are due to respiratory failure.¹ Among the congenital defects of the intrathoracic organs or supporting structures with surgical implications that present with respiratory distress are esophageal atresia with tracheal-esophageal fistula, mediastinal tumors and cysts, cystic disease of the lung, lobar emphysema, diaphragmatic hernia, patent ductus arteriosus, and pulmonary valvular stenosis. The presenting clinical pictures as seen at the bedside may be remarkably similar. The acute onset of dyspnea with varying degrees of cyanosis is common not only to these anatomical aberrations but to many medical and central nervous system lesions. It behooves the pediatrician and the surgeon to be constantly alert to the possibility of a surgically amenable lesion as the cause of progressive respiratory and circulatory failure. Early surgical correction of these defects is attended with a low mortality rate, and