A new variant of esophageal atresia with tracheoesophageal fistula and duodenal atresia: a diagnostic dilemma

1997 ◽  
Vol 12 (2-3) ◽  
pp. 186-187
Author(s):  
A. N. Gangopadhyay ◽  
S. P. Sahoo ◽  
C. K. Sinha ◽  
S. Chooramani Gopal ◽  
D. K. Gupta ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Duodenal Atresia ◽  
Diagnostic Dilemma ◽  
New Variant

A new variant of esophageal atresia with tracheoesophageal fistula and duodenal atresia: a diagnostic dilemma

1997 ◽  
Vol 12 (2-3) ◽  
pp. 186-187 ◽  
Author(s):  
C. K. Sinha ◽  
A. N. Gangopadhyay ◽  
S. P. Sahoo ◽  
S. Chooramani Gopal ◽  
D. K. Gupta ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Duodenal Atresia ◽  
Diagnostic Dilemma ◽  
New Variant

scholarly journals Congenital high airway obstruction syndrome (CHAOS) combined with esophageal atresia, tracheoesophageal fistula and duodenal atresia

2017 ◽  
Vol 26 ◽  
pp. 22-25 ◽  
Author(s):  
Yutaka Kanamori ◽  
Toshiko Takezoe ◽  
Kazunori Tahara ◽  
Toshihiko Watanabe ◽  
Michinobu Ohno ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Duodenal Atresia

scholarly journals Recurrent pneumonia-H type Tracheoesophageal fistula, diagnostic dilemma.

2014 ◽  
Vol 34 (1) ◽  
pp. 71-73
Author(s):  
S Adhikari ◽  
K Malla ◽  
P Poudyal
Keyword(s):  
Congenital Anomaly ◽  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Definitive Diagnosis ◽  
Diagnostic Dilemma ◽  
Recurrent Pneumonia ◽  
Rare Congenital Anomaly

Tracheoesophageal fistula (TEF) without associated esophageal atresia (EA) is a rare congenital anomaly.  Most of the children are treated for episodes of pneumonia prior to definitive diagnosis.  A 5 months infant presented with recurrent pneumonia and diagnosis of H type TEF was made with contrast esophagram.DOI: http://dx.doi.org/10.3126/jnps.v34i1.8517   J Nepal Paediatr Soc 2014;34(1):71-73

scholarly journals Crossover Upper Pouch in Type C Esophageal Atresia: An Uncommon Variant Causing Diagnostic Dilemma

2018 ◽  
Vol 7 (2) ◽  
pp. 23
Author(s):  
Shailesh Solanki ◽  
Ravi Prakash Kanojia ◽  
Ram Samujh
Keyword(s):  
Congenital Anomaly ◽  
Early Diagnosis ◽  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Morbidity And Mortality ◽  
Diagnostic Dilemma ◽  
Significant Length ◽  
Type C

Esophageal atresia with tracheoesophageal fistula (EA-TEF) is a well-known congenital anomaly and Type C variety of gross classification is the most common. Even for Type C variety, anatomy of upper pouch and lower pouch is not always the same. We are presenting three cases of Type C EA-TEF with unusual anatomy. In this type, upper pouch crosses over the lower pouch for a significant length. The cases are described here to highlight this variant of Type C EA-TEF which produces diagnostic dilemma. An early diagnosis of this variant, prevents morbidity and mortality.

scholarly journals New Variant of Esophageal Atresia

2016 ◽  
Vol 6 (1) ◽  
pp. 9 ◽  
Author(s):  
Swapnil Harne ◽  
Manish Pathak ◽  
Kamal Nayan Rattan
Keyword(s):  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Esophageal Stenosis ◽  
Congenital Esophageal Stenosis ◽  
New Variant

Esophageal atresia with tracheoesophageal fistula (EA/TEF) associated with distal congenital esophageal stenosis (CES) is a well-known entity. We encountered three patients of EA/TEF associated with long and unusual CES.

COMBINATION OF ESOPHAGEAL ATRESIA WITH TRACHEOESOPHAGEAL FISTULA AND DUODENAL ATRESIA: TREATMENT ANALYSIS OF FIFTEEN PATIENTS

2021 ◽  
Vol 100 (6) ◽  
pp. 45-53
Author(s):  
I.N. Khvorostov ◽  
◽  
N.K. Barova ◽  
S.V. Minaev ◽  
M.A. Akselrov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Esophageal Atresia ◽  
Gestational Age ◽  
Tracheoesophageal Fistula ◽  
Postoperative Mortality ◽  
Duodenal Atresia ◽  
Two Stage ◽  
Results Of Treatment ◽  
Esophageal Anastomosis ◽  
Overall Mortality

The combination of duodenal atresia (DA) with esophageal atresia with tracheoesophageal fistula (EA-TEF) is a rare pathology, the frequency of which ranges from 1% to 6% of all cases of EA. Surgical treatment of the DA+EA-TEF combination always causes significant difficulties, primarily in determining the timing and stages of surgical correction. Objective of the study: to evaluate the results of treatment with a combination of DA+EA-TEF to determine the effective tactics of surgical treatment. Materials and methods of research: a retrospective, nonrandomized, uncontrolled, multicenter study was carried out. The work is based on the results of treatment of 15 newborns – 6 (40%) boys, 9 (60%) girls with a combination of DA+EA-TEF, who were treated in clinics of 6 university centers for pediatric surgery in the Russian Federation in 2015–2021. Simultaneous operations (SIMOPs) were performed in 10 (60%) patients, two-stage operations (TO) – in 5 (40%) newborns. The following criteria were taken into account: the period of antenatal (weeks) and postnatal (days) of establishing the diagnosis of obstruction of the gastrointestinal tract (GIT), gestational age (weeks), birth weight (g), weight at the time of surgery (g), type of concomitant pathology , sequence and methods of surgical treatment, terms of complete enteral feeding (days), outcomes of operations and reasons for unsatisfactory outcomes. The average gestational age of children who underwent SIMOPs was 35.1 weeks. (Q1 – 31.5, Q3 – 39; Me – 37; SD – 5.1; min/max – 25–40; 95% CI: 31.1–39.0) versus 29.8 weeks. at DO (Q1 – 29, Q3 – 30.5; Me – 30; SD – 1.0; min/max – 28–31; 95% CI: 28.4–31.6) did not differ statistically significantly (р=0.083). The mean body mass values did not have statistically significant differences (p=0.081) and amounted to 2224 g (Q1 – 1410, Q3 – 2930; Me – 2665; SD – 890.8; min/max – 760–3260; 95% CI: 1556–2926) for SIMOPs, versus 1322 g (Q1 – 1165, Q3 – 1450; Me – 1380; SD – 196; min/max – 980–1450; 95% CI: 1078.4–16565) in the TO group. Results: the average duration of SIMOPs was on average 144.4 min (Q1 – 125, Q3 – 155; Me – 147.5; SD – 22; min/max – 120–190; 95% CI: 1321–159.3), TO – 147.0 (Q1 – 125, Q3 – 172; Me – 140; SD – 33.4; min/max – 120–205; 95% CI: 126–178.6). The sequence of surgical correction of defects in SIMOPs in 8 (53%) patients consisted of thoracotomy, ligation of the TEF, direct anastomosis of the esophagus and the imposition of duodeno-duodenoanstomosis (DDA). In one case, DDA was selected as the first operation, which was supplemented with Kader gastrostomy followed by thoracotomy, ligation of the TEF and anastomosis of the esophagus after elongation according to I. Livaditis. In one patient, after thoracotomy and ligation of the TEF in connection with an insurmountable diastasis of the esophagus, a cervical esophagostomy (CE), duodenojejunoanastomosis (DEA) and a gastrostomy according to Kader were applied. In a two-stage correction (TO), the first operation in 3 patients was DDA (20%), supplemented in one case (7%) with Kader gastrostomy, and the second stage after 2 days performed thoracotomy with the elimination of TEF and EA. In 2 (13%) newborns, the first stage was thoracotomy, elimination of TEF and EA, followed by imposition of DDA 2 days later. In one case, due to an insurmountable diastasis of the esophagus after thoracotomy and ligation of the TEF, intrathoracic elongation of the esophagus according to Foker with delayed anastomosis of the esophagus (on the 7th day) and laparoscopic fundoplication according to Nissen (at 5 months) were performed. The duration of hospitalization did not statistically significantly depend on the chosen method for correcting the combination of DA+EA-TEF (p=0.79) and averaged 28.4 days for SIMOPs (Q1 – 16, Q3 –34.5; Me – 26; SD – 21.4; min/max – 5.0–79; 95% CI: 17.6–42.4), and for TOs – 27,2 days (Q1 – 21, Q3 – 33; Me – 28; SD – 7.1; min/max – 19–38; 95% CI: 27.2–33). In the group of patients with SIMOPs, 2 deaths (13%) were recorded on the 5th and 7th days after surgery due to progressive multiple organ failure and intractable pulmonary hypertension. In one case (7%), a lethal outcome was recorded 8 months after primary surgery due to progressive cardiovascular failure. Early postoperative mortality after SIMOPs was 20%, overall mortality was 30%. In the TO group, 3 (20%) deaths were recorded: 2 in the early postoperative period (on day 3 and day 19) and one at the age of 3 months of life. Early postoperative mortality after TO was 40%, overall mortality – 60%. Conclusion: it is preferable to choose the ligation of the TEF as the first operation and, if the child's condition allows, to impose an esophageal anastomosis and restore duodenal patency, followed by a nasogastric tube through the esophageal anastomosis into the stomach. If, after ligation of the TEF, the patient's cardiorespiratory status does not stabilize, it is possible to restore the patency of the esophagus and pass the probe into the stomach without imposing a gastrostomy, which will allow the patient to be further treated as an isolated DA, and the operation to restore the patency of the duodenum is delayed. In the presence of insurmountable diastasis, the use of esophageal elongation technology with subsequent delayed EA is justified.

scholarly journals Prenatal and Postnatal Diagnostics Problems of the Most Common Surgical Congenital Malformations of Newborns in Latvia

2009 ◽  
Vol 63 (4-5) ◽  
pp. 159-162
Author(s):  
Zane Ābola ◽  
Aigars Pētersons ◽  
Daila Pugačevska ◽  
Astra Zviedre ◽  
Jana Lackaja
Keyword(s):  
Abdominal Wall ◽  
Esophageal Atresia ◽  
Congenital Malformations ◽  
Tracheoesophageal Fistula ◽  
Duodenal Atresia ◽  
University Hospital ◽  
Abdominal Wall Defects ◽  
Postnatal Diagnosis ◽  
Expectant Mothers

Prenatal and Postnatal Diagnostics Problems of the Most Common Surgical Congenital Malformations of Newborns in Latvia The most common surgical congenital malformations of newborns in Latvia are esophageal atresia (EA) with or without tracheoesophageal fistula (TEF), duodenal atresia (DA) and abdominal wall defects — gastroschisis (G) and omphalocele (O). Survival and quality of life of these patients depend on precise pre- and postnatal diagnosis, timely and qualified treatment, and presence of associated anomalies and prematurity. The aim of our study was to define prenatal and postnatal diagnostic problems of the most common surgical congenital malformations of new-borns in Latvia. Data concerning pre- and postnatal diagnostics from case-records of patients treated in Children's Clinical University Hospital from 1998 till 2008 with esophageal atresia (58 patients), duodenal atresia (20 patients) and congenital abdominal wall defects — gastroschisis (17 patients) and omphalocele (28 patients) were analysed. Results showed that in case of EA prenatal USG was performed in 62% of expectant mothers and in neither case suspicion about. EA was expressed. In all patients after birth diagnostic placement of nasogastric tube was performed. In approximately one-third catheter of bad opaqueness was used. Preoperative bronchoscopy and esophagoscopy in order to exclude upper tracheoesophageal fistula were performed in two patients from the analysed group. In 40% of cases DA was diagnosed in prenatal ultrasonography. G was diagnosed prenatally in 29.4%, O — only in 3.7%.

Congenital high airway obstruction syndrome complicated with foregut malformation and high airway fistula to the alimentary tract – a case series with four distinct types

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Yutaka Kanamori ◽  
Kazunori Tahara ◽  
Michinobu Ohno ◽  
Kotaro Tomonaga ◽  
Yohei Yamada ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Airway Obstruction ◽  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Alimentary Tract ◽  
Correct Diagnosis ◽  
Case Series ◽  
Duodenal Atresia ◽  
Case Presentation ◽  
Foregut Malformation

AbstractBackgroundCongenital high airway obstruction syndrome (CHAOS) is a rare disease and recently has been noticed to show typical prenatal images, such as hyperinflated lungs and flattened or inverted diaphragms. However, in some cases correct diagnosis may be difficult and in such cases the mortality rate increases.Case presentationWe report four cases of CHAOS complicated with a high airway fistula to the alimentary tract and foregut malformation. The patients did not show the typical features of CHAOS in the fetus. This may be attributed to the high airway fistula acting as a decompression route for the accumulated lung fluids to the alimentary tract.ConclusionThe combination of CHAOS, foregut malformation and a high airway fistula is very rare and classified into four distinct types: (1) CHAOS with a high airway fistula but not with a foregut malformation; (2) CHAOS with esophageal atresia and tracheoesophageal fistula; (3) CHAOS with a high airway fistula and duodenal atresia; and (4) CHAOS with esophageal atresia, tracheoesophageal fistula and duodenal atresia. It may be useful for treating physicians to be aware of these four distinct types and the typical characteristics of each type.

scholarly journals Preterm Infant with Congenital Tracheal Diverticulum in the Presence of Esophageal Atresia and Tracheoesophageal Fistula

2018 ◽  
Vol 7 (4) ◽  
pp. 44
Author(s):  
Alessandra Glover Williams ◽  
Janet McNally ◽  
Julian Gaskin ◽  
Ela Chakkarapani
Keyword(s):  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Primary Anastomosis ◽  
Work Of Breathing ◽  
Three Dimensional ◽  
Respiratory Acidosis ◽  
Positive Pressure ◽  
Diagnostic Dilemma ◽  
Tracheal Diverticulum ◽  
Dimensional Reconstruction

A 32+4-week-preterm neonate was operated on day 1 for esophageal atresia with tracheoesophageal fistula with a tight primary anastomosis and closure of a tracheoesophageal fistula. Postoperatively, he needed ventilation for 6 days. Post-extubation, he needed continuous positive airway pressure support for increased work of breathing, increasing oxygen requirement, and respiratory acidosis when respiratory support was weaned. Further, during the post-operative period, he had right hemidiaphragmatic paresis and acute lifethreatening events requiring manual high-pressure, non-invasive positive pressure ventilation resuscitation. These complications were considered, and a computed tomography assisted by three-dimensional reconstruction was performed. This revealed a congenital tracheal diverticulum and severe tracheomalacia which was confirmed with microlaryngoscopy and bronchoscopy. The presentation and the diagnostic dilemma surrounding this rare diagnosis are discussed in this case report.

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