The esophageal ‘pouch sign’: a benign transient finding

2010 ◽  
Vol 30 (9) ◽  
pp. 845-848 ◽  
Author(s):  
Ido Solt ◽  
Siegfried Rotmensch ◽  
Moshe Bronshtein
Keyword(s):  
Esophageal Pouch

Unusual Nasogastric Tube Position Leading to Delay in Diagnosis of Tracheoesophageal Fistula

2021 ◽  
pp. 097321792110367
Author(s):  
Monika Kaushal ◽  
Saima Asghar ◽  
Ayush Kaushal
Keyword(s):  
Early Diagnosis ◽  
Nasogastric Tube ◽  
Common Type ◽  
X Ray ◽  
Delay In Diagnosis ◽  
Atypical Symptoms ◽  
Tube Position ◽  
Esophageal Pouch ◽  
High Index Of Suspicion ◽  
Surgical Unit

Aim: This case highlights the importance of high index of suspicion for early diagnosis and thorough clinical examination of a newborn with tracheoesophageal atresia and fistula. Case Report: We report a case of most common type of tracheoesophageal atresia with fistula where diagnosis was missed due to unusual gastric position of nasogastric tube. Nasogastric tube reached stomach in esophageal atresia with fistula, delaying the diagnosis and management of condition. After accidental removal of tube and failure to pass again raised suspicion and was confirmed with coiled tube in esophageal pouch in X-Ray chest. Baby shifted to surgical unit for treatment, fortunately baby recovered and discharged home after surgical correction. Conclusion: Tracheoesophageal atresia with fistula can present with atypical symptoms and unusual events, challenging the early diagnosis and treatment of common types of conditions. Other association like VACTERL should be looked for, in patients.

Tracheoesophageal Fistula Repair

2018 ◽  
Author(s):  
Catherine P. Seipel ◽  
Titilopemi A. O. Aina
Keyword(s):  
Postoperative Analgesia ◽  
Nasogastric Tube ◽  
Tracheoesophageal Fistula ◽  
Imaging Finding ◽  
Anesthetic Management ◽  
Radiographic Imaging ◽  
Fistula Repair ◽  
Live Births ◽  
Vertebral Anomalies ◽  
Esophageal Pouch

Tracheoesophageal fistula (TEF) with esophageal atresia (EA) is a congenital malformation occurring in approximately 1:4,000 live births. TEF/EA is characterized by disrupted continuity of the esophagus. There are five distinct types, but the most common is EA with a distal TEF. Most cases are diagnosed postnatally after an inability to pass a nasogastric tube (NGT), with subsequent radiographic imaging finding the NGT coiled within the esophageal pouch. The anesthetic management of TEF/EA repair can be complicated by the presence of cardiac, renal, and vertebral anomalies. Additionally, ventilation can be challenging, and care must be taken to minimize insufflation of the stomach through the fistula. Postoperative analgesia should include consideration of intravenous opioids, nonopioid adjunct medications, and regional and neuraxial techniques.

Esophageal Atresia and Tracheoesophageal Fistula: Supportive Measures That Affect Survival

PEDIATRICS ◽  
1974 ◽  
Vol 54 (5) ◽  
pp. 558-564
Author(s):  
C. Everett Koop ◽  
Louise Schnaufer ◽  
A. Michael Broennle
Keyword(s):  
Survival Rate ◽  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Surgical Care ◽  
Full Term ◽  
Recent Experience ◽  
Term Infants ◽  
Technical Problems ◽  
Surgical Technical ◽  
Esophageal Pouch

The survival of infants with esophageal atresia with or without tracheoesophageal fistula has been analyzed over a 24-year period divided into three eras of five years each depending upon the quality of intensive care available and the most recent nine years' experience. Early diagnosis and skillful transportation to definitive surgical care are essential. Diagnosis by x-ray with a coiled catheter in the upper esophageal pouch without the use of radiopaque material is beneficially reflected in a decreased incidence of pneumonia and a reduced mortality. The skills of anesthesia carried over into close supervision of respiratory care postoperatively have further increased the salvage rate of these infants. As surgical technical problems have been overcome, the percentage of deaths due to associated major anomalies and pneumonia and/or sepsis has increased. Invasive techniques for diagnosis, for monitoring, and for treatment do not seem to be responsible for the sepsis. In the most recent experience with 134 patients over nine years the overall survival was 66%; full-term infants had a 70% survival while the survival rate for prematures was 52%. In full-term infants without pneumonia and without a major associated congenital anomaly, the survival rate was 100% (44 patients). Clearly the target for improvement in survival is the prevention of and the improvement in treatment of pneumonia and sepsis.

Intestinal Obstruction in the Newborn

1994 ◽  
Vol 15 (9) ◽  
pp. 338-347 ◽  
Author(s):  
Arthur J. Ross
Keyword(s):  
Intestinal Obstruction ◽  
Newborn Infant ◽  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Clinical Aspects ◽  
Gi Tract ◽  
Live Births ◽  
Esophageal Pouch

Obstruction of an infant's gastrointestinal (GI) tract can occur anywhere from the esophagus to the anus. For purposes of this review, the newborn infant will be defined as an infant from birth to 30 days of age. Both congenital and acquired obstructions will be addressed. In each instance, the epidemiology, pathogenesis, clinical aspects, and management of the disorder will be considered. Esophageal Atresia EPIDEMIOLOGY AND PATHOGENESIS Esophageal atresia, or interruption of the esophagus, generally occurs in association with a tracheoesophageal fistula (EA - TEF). The most common anatomic arrangement is a blind proximal esophageal pouch that has a distal tracheoesophageal fistula (Figure 1). This is seen in 85% to 90% of infants who have this anomaly. Seen less commonly is pure esophageal atresia that does not have a tracheoesophageal fistula and tracheoesophageal fistula that does not have an esophageal atresia (H-type tracheoesophageal fistula). These latter two conditions occur in approximately 10% of newborns who have these types of anomalies. Other anatomic arrangements, such as an esophageal atresia that has a fistula between the upper pouch and trachea or esophageal atresia that has a fistula to both pouches, are seen in only a tiny fraction of these infants. EA - TEF occurs in approximately 1 in 4000 live births.

Palatability and postprandial thermogenesis in dogs

1985 ◽  
Vol 248 (1) ◽  
pp. E75-E79 ◽  
Author(s):  
P. Diamond ◽  
L. Brondel ◽  
J. LeBlanc
Keyword(s):  
Initial Phase ◽  
Tube Feeding ◽  
Specific Dynamic Action ◽  
Second Phase ◽  
Biphasic Response ◽  
Standard Meal ◽  
The Third ◽  
Esophageal Pouch ◽  
Postprandial Thermogenesis

The role of palatability on postprandial thermogenesis was determined in six mongrel dogs of approximately 16 kg. Oxygen uptake (VO2) was continuously monitored by indirect calorimetry for 1 h before and 2 h after a standard meal of 1,390 kcal. In the first experiment each dog was given access to the meal, which was ingested within 5 min. In a second experiment the same meal was sham fed and collected into an esophageal pouch. In a third experiment the dogs were tube fed. In the first experiment a biphasic response was found in the postprandial increase in metabolic rate; a first phase lasting approximately 40 min and the other from 40 to 125 min. In the second experiment the increase in VO2 was comparable with that of the first experiment for the first 40 min but almost abolished for the remaining period; the sight and smell of food alone produced a similar effect. In the third experiment tube feeding caused a small increase in VO2, which was four times smaller than that found in both the first and the second experiment during the initial phase. However, during the second phase the increase in VO2 was comparable with that of experiment 1. An initial phase of feeding lasting approximately 40 min is identified with food palatability, whereas the second phase would correspond to a large extent to specific dynamic action of food.

C. A Proposed Operation for the Relief of Congenital Atresia of the Esophagus.

1934 ◽  
Vol 43 (4) ◽  
pp. 1147-1153 ◽  
Author(s):  
Samuel Iglauer
Keyword(s):  
Two Stage ◽  
Congenital Atresia ◽  
Lower Esophagus ◽  
Esophageal Pouch ◽  
Stage 1

A two-stage operation is proposed for the relief of congenital atresia of the esophagus: Stage 1. Cervical esophagostomy for drainage of the blind esophageal pouch. Stage 2. A transthoracic operation for the externalization of the lower esophagus, i. e., dorsal esophagostomy for feeding purposes. I wish to express my indebtedness to Dr. Richard Austin of the Pathological Department for anatomic material, and to Mr. Philip Goland for assistance in dissections.

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