Esophageal atresia & tracheoesophageal fistula (Year of the Zebra)
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- เผยแพร่เมื่อ 8 ก.ย. 2024
- CC-BY-NC-ND
Esophageal atresia and tracheoesophageal fistula are congenital gastrointestinal anomalies where the esophagus and trachea don’t separate normally during development.
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Esophageal atresia and Tracheo-esophageal fistula = congenital GI anomalies. Esophagus and trachea don't separate normally during development.
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Normal development: they both form from primitive foregut during weeks 4-6 of intrauterine development, afterwards being separated by Tracheo-esophageal septum which divides foregut into laryngotracheal tube anteriorly, and esophagus posteriorly.
Laryngotracheal tube becomes larynx and trachea; oesophagus elongates and connects to stomach.
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Exact cause of atresia and fistula is unknown, but environment and genetics play a role. Risk factors:
Prenatal maternal use of alcohol, smoking, uncontrolled diabetes, increased maternal age, exposure to methimazole & diethylstilbestrol.
Chromosomal anomalies like trisomy 13, 18, or 21
Vacteral syndrome (Assoc. W/ spinal, anal, renal, limb, heart anomalies and Tracheo-esophageal fistulas)
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Pathology:
Esophageal atresia : failure of esophagus to elongate and connect to stomach around week 4 of intrauterine development.
Proximal oesophagus ends in a blind pouch and distal oesophagus ending right above diaphragm. Commonly assoc. W/ Tracheo-esophageal fistula, a connection between trachea and one of/both parts of oesophagus.
Types of Fistulae:
Type A/Isolated oesophageal atresia : middle part of oesophagus is missing.
Type B: proximal oesophagus communicates with trachea
Type C (most common): proximal oesophagus atresia, and distal oesophagus communicates with trachea
Type D: middle part of oesophagus is missing, both prox and dist oesophagus communicate with trachea
Type E/Type H: there is no oesophageal atresia (i.e. prox and dist oesophagus are connected), but there is a Tracheo-esophageal fistula.
*When the distal part of the esophagus is connected to the trachea, Gastric distention appear as air reaches the stomach via the fistula
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Complications: aspiration pneumonia, lung abscesses, bronchiectasis due to recurrent aspiration.
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After operations, there can be
-leaking at site of anastomosis (connection of prox and dist oesophagus surgically)
-strictures ( Abnormal narrowing of a canal or duct in the body)
-formation/return of preexisting Tracheo-esophageal fistula
-impaired oesophageal motility + gastro-esophageal reflux, increasing risk of recurrent pneumonia and other respiratory problems.
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Clinical manifestations of oesophageal atresia in prenatal period:
Polyhydramnios as fetus doesn't swallow amniotic fluid normally
Absence of stomach gas on prenatal abdominal echography.
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Postnatal symptoms:
Frothy saliva in mouth and nose
Excessive drooling
Imability to swallow feedings
Vomitting
Abdomnial distention
Respiratory distress (in severe cases).
*Key clinical presentations of esophageal atresia: coughing, choking during feeding, cyanosis
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Clinical presentations of Tracheo-esophageal fistula : coughing, choking during feeding, cyanosis, increased risk of aspirational pneumonia (when esophageal contents reach the lungs), respiratory distress , malaise, fever.
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Chest x-rays are used to diagnose.
Surgical correction is the only treatment.
Why cyanosis in eso. Atresia?
Thanks for the video. I really liked it when you summarised on one slide, hope you still continue that.
Thanks, Alice! 😊
You should have added the name of surgical procedure
Cameron Haights procedure and the role of N myc gene
My 2 month old twin baby girl has this, she had surgery right after birth and is currently still in Nicu, her twin sister is home and has no issues they are mono mono Identical twin girls. I never smoked, drank, no health issues . She will be coming home on a feeding tube
Hmm.. are You sure, that there is no connection between the esophagus and stomach at this stage ? I found no studies/evidence for it... Most authors assume that the whole gut is some kind of a tube at the 4th-5th week..
Very good explaination of the condition....thank you so much
Glad you liked it, Smriti! 😊
Love you osmosis 😍💕💕 u r the best
Thank you! 🙏🏼
thank you, osmosis club
Most welcome, Ridha! ❤️
So helpful ❤️
Glad it was helpful, Menna! 🥰
thank you! getting me through my ent exam lol
Happy to help! 💕
Thank you it was amazing
You're welcome, Shakila! 😊
Great way of explaining✅️
We hope it helped, Elda! 💖
My first baby has suffered with both of these problems and died after surgery with in 15 days...I have a doubt and worried whether this kind of problems repeat for second child
thank u so much for this excellent explanation
🙌🏼 💕 ✨
Informative
Now my son facing recurrent tef...type c tef baby...
Done one time dilation... doctors said need 2 dilation...
Please give me is there any permanent solution...to my baby please
What are the expected outcomes?
learn more
Cool❤
Thanks! 🙏🏼
🎉
Where is the research that alcohol or medication can cause this? Sometimes people like myself do not know they are pregnant for the first 4-6 weeks. My surgeons and research have stated that any alcohol or behavior of pregnant woman can not cause this. So please state where these studies have been done?
If you wanna find research papers, look for it yourself. It's not their job to spoon feed your demands. They are an illustrated education page. Also it's a well known fact that drinking while pregnant is really bad for you. But if you wanna do it while you're pregnant, go ahead by all means.
Don't listen to this rude person who replied to your comment ❤
Well, it is really not a well established case where there is full proof of how alcohol intake can cause diseases such as the one in discussion...Actually, for many congenital anomalies in babies, there is a dynamic interplay of different factors that can actually cause several disorders and unfortunately alcohol is one of them...Its not that alcohol intake itself can cause the disease no, but its the intake, plus other confounding factors that may play a part,such as genetic factors and environmental factors may lead to several anomalies...Better to be safe than never right?...So to be on the safe side, when one is pregnant, it is advised that they do not take alcohol just to ensure full growth of the baby and guarantee their full development 😊...Hopefully this helps
Doctors don’t know what causes this
My son had this birth defect
My son have 3rd type condition..😭
Hai ...my son also have same issue ... what about your baby health condition... brother..
Where you taking clinical procedure
@@vijayakumarsheelam kanpur, by dr rakesh tripathi
@@ashishkuamr882 how is your baby health now...
I hope all your babies are doing well and continue to do so 🙏🏾
👍🏿💯
Ugh. That does not sound fun. 😬