Flashcards in 2. Tracheoesophageal anomalies Deck (14)
1. Pure esophangeal atresia or stenosis
2. Pure tracheosophageal ( H- type)
3. Esophangeal atresia with distal tracheoesophageal fistula ( MC -85%)
tracheosophageal anomalies - clinical presentation
1. Polyhydramnios in utero.
2,Neonates drool, choke, and vomit with first feeding. 3.allows air to enter stomach (visible on CXR). 4.Cyanosis is 2° to laryngospasm (to avoid reflux-related aspiration).
CXR of abdomen
1. Pure esophangeal atrsia or stenosis --. GASLESS ABDOMEN
2. Pure tracheosophageal --> air in stomach
3. Esophangeal atresia with distal tracheoesophageal fistula --> air in stomach
failure to pass nasograstric tube into stomach
Interstinal atresia presents with
bilious vomiting ( with bile ) and abdominal distention within first 1-2 days of life. Proximal atresia is also presented with polyhydramnios
Interstinal atresia - types
1. duodenal atresia
2. jejunal and ileal atresia
duodenal atresia - mechanism / finding s
failure to recanalize --> dilation of stomach and proximal duodenum ( DOUBLE BUBBLE on x-ray)
jejunal and ileal atresia - mechanism / findings
disruption of mesenteric vessels---> ischemic necrosis ---> segmental resorption ( bowel discontinuity or ''apple peel")
duodenal atresia is associated with
• What is the most common subtype of tracheoesophageal fistula?
Esophageal atresia (a blind-pouch upper esophagus with the lower esophagus connected to the trachea)
• What are some symptoms seen with the most common subtype of tracheoesophageal fistula?
Cyanosis, choking, and vomiting with feeding, air bubble on x-ray of the chest (or polyhydramnios, if still in utero)
• A patient's CXR shows an airway stricture. He is drooling excessively. How do you confirm your suspected diagnosis?
Attempt to pass a nasogastric tube (in a tracheoesophageal fistula, the tube will not reach the stomach)
• A newborn chokes and vomits with the first feeding, and she reportedly had polyhydramnios in utero. Why might this baby become cyanotic?
The newborn may develop cyanosis from laryngospasm (to avoid reflux-related aspiration) (this is a tracheoesophageal fistula)