Q Zhang, S Jiang, G Yan, M Wu

Abstract

Congenital High Airway Obstruction Syndrome (CHAOS) is a rare and critical neonatal condition characterized by upper airway defects, often accompanied by tracheoesophageal fistula (TOF). Concurrent esophageal atresia (EA) is exceedingly rare, complicating intubation efforts. We present a case of a preterm male neonate with CHAOS, TOF, EA, and duodenal atresia, who experienced unexpected failure in both tracheal and esophageal intubation despite prior TOF confirmation. The case underscores the importance of thorough antenatal examination for early diagnosis and highlights the need for innovative tracheal replacement strategies. Timely and appropriate airway management is crucial for improving prognosis in such cases. This report aims to raise awareness and guide clinical preparedness for managing infants with CHAOS and EA. Future research should focus on identifying superior tracheal replacement options.