Tuesday, April 2, 2013

Tracheoesophageal And Bronhoesophageal Fistulas

Tracheoesophageal and bronchoesophageal fistulas manifest themselves at the first feeding of the child by severe attack of asphyxia, cough and cyanosis. Quickly severe aspiration pneumonia occurs and is usually fatal in saved hernia. This defect is often combined with atresia of the esophagus. It is diagnosed with the introduction of X-ray contrast into the trachea and bronchi, or bronchoscopically with the introduction of contrast into the esophagus.
                  Clinical manifestations of this defect depend on the width of the message of the esophagus with the trachea. The wider the anastomosis, the more rapidly and early clinical symptoms arise. Any form of congenital isolated tracheoesophageal fistula mainly manifests is respiratory failure (cyanosis, shortness of breath, coughing, choking) that occur during breastfeeding. This relationship of breathing disorders in feeding is the cardinal symptom, distinguishing esophageal-endotracheal anastomosis from other types of diseases in neonates, occurring respiratory disorders. With a wide fistula respiratory failure is so severe that requires removal of the child on mechanical ventilation. Suction of gastric contents in this case from the intubation tube (tracheal) makes the diagnosis tracheoesophageal fistula uncertain.
           Radiograph of the chest. Radiocontrast substance is flowing through the tracheoesophageal fistula from the esophagus to tracheobronchial tree.

              Surgical treatment must be performed as soon as possible. In this case the prognosis for life is good.
                Although congenital lung malformations are rare, they are important disorders because they may lead to considerable morbidity and mortality (eg, infection, hemorrhage, respiratory failure). Prognosis depends on the size of the lesion, and the degree of functional impairment. Small lesions may remain asymptomatic. Failure to recognize a malformation may lead to inappropriate intervention. 

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