1/16. Bilateral congenital choanal atresia and absence of respiratory distress.Bilateral congenital choanal atresia is considered a lethal congenital malformation in an obligatory nasal breathing neonate. Described herein are two cases of bilateral choanal atresia associated with craniofacial anomalies who did not present respiratory distress in the neonatal period. Our first patient had a complete unilateral cleft lip which facilitated oropharyngeal respiration. The second patient presented wory distress in the neonatal period by providing an oropharyngeal airway.- - - - - - - - - - ranking = 1keywords = choanal atresia, choanal, atresia (Clic here for more details about this article) |
2/16. Traumatic retropharyngeal emphysema as a cause for severe respiratory distress in a newborn.Traumatic injury to the pharynx or esophagus in a newborn from intubation or tube suctioning may have various presentations. Difficulty passing a gastric tube or feeding problems may erroneously suggest the diagnosis of esophageal atresia. Associated respiratory distress may be caused by pneumothorax or pleural effusion if the pleural space is entered. We report the case of a full-term newborn presenting with severe respiratory distress caused by a large retropharyngeal air collection resulting from hypopharyngeal perforation from prior intubation and suctioning. Chest abnormality, sufficient to account for the degree of respiratory distress, was not demonstrated.- - - - - - - - - - ranking = 0.0063435723310185keywords = atresia (Clic here for more details about this article) |
3/16. Atretic, obstructive proximal duodenal mass associated with annular pancreas and malrotation in a newborn male.A case is described of duodenal atresia involving the first portion of the duodenum associated with a partial annular pancreas, complete nonrotation and nonfixation of the intestines, and a congenitally small glottic region in a newborn male. The atretic segment was a 1.3 cm mass adjacent to the pylorus unlike previous reports of duodenal atresia. The diagnosis was delayed for seven days until the child was fed and had bowel movements. Pyloroduodenostomy was performed resulting in cure. An older sibling had a duodenal web requiring previous duodenoduodenostomy.- - - - - - - - - - ranking = 0.012687144662037keywords = atresia (Clic here for more details about this article) |
4/16. Non-pulmonary causes of acute respiratory distress in neonates: report of two cases.Acute respiratory distress (ARD) in neonates is a dangerous condition that is usually brought on by pulmonary dysfunction. Congenital diaphragmatic hernia and oesophageal atresia with tracheo-oesophageal fistula are examples of non-pulmonary causes of acute respiratory distress. Though rare, they are potentially fatal and successful management entails a multidisciplinary approach, which includes surgical intervention, use of critical care facilities such as the intensive care unit and paediatric supervision. We present two cases, each outlining one of the above named non-pulmonary causes of ARD, its management and outcome. Management of the congenital diaphragmatic hernia (CDH) was successful and the baby is still doing well. The baby with oesophageal atresia (OA) died during treatment, though the therapeutic procedures undertaken are presented here for academic purposes.- - - - - - - - - - ranking = 0.012687144662037keywords = atresia (Clic here for more details about this article) |
5/16. esophageal atresia and severe respiratory failure--cuffed pediatric tracheal tubes as an additional therapeutic option?This article describes the use of a cuffed pediatric endotracheal tube occluding selectively the air leakage resulting from tracheoesophageal fistula in a preterm neonate with esophageal atresia and severe respiratory failure due to respiratory distress syndrome. The gastric distension resolved completely within 4 hours. Surgical correction was performed on the third day of life after respiratory stabilization.- - - - - - - - - - ranking = 0.031717861655092keywords = atresia (Clic here for more details about this article) |
6/16. Unilateral pulmonary agenesis associated with colloidal goiter in a newborn: a case report.Unilateral pulmonary agenesis is a very rare developmental malformation that is often associated with other anomalies. It can be asymptomatic or present with respiratory symptoms. Our case is a female newborn infant who had been taken to the hospital suffering from difficulty in breathing at the first day of birth. The baby died at the age of three days due to respiratory failure. On autopsy examination and its histopathological evaluation, we detected right pulmonary agenesis and colloidal goiter. According to the literature, pulmonary agenesis is associated with other anomalies including esophageal atresia, tracheal stenosis, musculoskeletal anomalies, digeorge syndrome and cardiovascular malformations such as septal defects, patent ductus arteriosus and total anomalous pulmonary venous return. To our knowledge, this is the first case of pulmonary agenesis associated with colloidal goiter.- - - - - - - - - - ranking = 0.0063435723310185keywords = atresia (Clic here for more details about this article) |
7/16. Apertura pyriformis stenosis in the newborn.Apertura pyriformis stenosis in the newborn. Respiratory distress in the newborn can have a variety of aetiologies, the best known of which are cardiac and pulmonary diseases. Major nasal airway obstruction is probably often overlooked when acute desaturation of the neonate requires reanimation procedures, although it is well established that the baby is an obligate nose breather at birth. Nasal airway stenosis or atresia could account for a number of unexplained deaths in the delivery room. In the differential diagnosis of major nasal airway obstruction in the newborn, choanal atresia is by far the most common aetiology. However, a few cases of pyriform aperture stenosis have been reported. One child presenting this pathology was recently treated at the Brussels University Children's Hospital. Unexpectedly, the baby survived until 3 months without any medical support but had severe feeding problems. The diagnosis was confirmed by naso-sinusal CT scan. Surgery was performed at 4 months through an unusual endonasal approach which seems to be less traumatic than the classical sublabial approach. The post-operative course was satisfactory. The 9-month-old patient does not now show residual breathing problems. The presentation will focus on this unusual case.- - - - - - - - - - ranking = 0.17301023899769keywords = choanal atresia, choanal, atresia (Clic here for more details about this article) |
8/16. Respiratory distress syndrome and tracheoesophageal fistula: management with high-frequency ventilation.An 1180-g infant with esophageal atresia and tracheoesophageal fistula developed life-threatening respiratory distress syndrome. Conventional mechanical ventilation resulted in gastric perforation and pneumoperitoneum. High-frequency ventilation stabilized the infant, permitting distal occlusion of the esophagus with a Silastic band. Fistula ligation was subsequently performed under more optimal physiologic conditions.- - - - - - - - - - ranking = 0.0063435723310185keywords = atresia (Clic here for more details about this article) |
9/16. "Waterseal" gastrostomy in the management of premature infants with tracheoesophageal fistula and pulmonary insufficiency.The perioperative management of premature infants with esophageal atresia and tracheoesophageal fistula (EA/TEF) complicated by pulmonary insufficiency continues to be a challenge. Definitive repair is usually delayed or staged and a gastrostomy is initially placed to prevent reflux aspiration. In patients with decreased pulmonary compliance, gastrostomy placement results in decreased intragastric pressure leading to a loss of ventilatory pressure via the tracheoesophageal fistula. A technique using the principle of underwater seal to maintain effective ventilatory pressure after gastrostomy placement is described, and two illustrative cases are presented. After acute respiratory decompensation in these patients, the gastrostomy tube was connected to underwater seal resulting in improved respiratory status. The underwater seal is allowed to intermittently "bubble," thereby permitting partial gastric decompression. This technique maintains effective ventilatory pressure after gastrostomy placement in premature infants with EA/TEF and pulmonary insufficiency until definitive therapy can be achieved.- - - - - - - - - - ranking = 0.0063435723310185keywords = atresia (Clic here for more details about this article) |
10/16. Management of esophageal atresia and tracheoesophageal fistula in the neonate with severe respiratory distress syndrome.In a 10-year period, 22 neonates with esophageal atresia (EA) and tracheoesophageal fistula (TEF) required high pressure ventilatory support soon after birth because of respiratory distress syndrome (RDS). Eleven of the 22 or 50% survived overall, but if the 5 patients who died before definitive surgical repair could be attempted are excluded, 11 of 17 or 65% survived. More importantly, 4 of 7 (57%) patients who had gastrostomy performed first survived while 7 of 10 (70%) who had fistula ligation performed first survived. The difficulties with intraoperative management of those who had gastrostomy performed first were even more impressive. Our experience leads us to conclude that patients with EA and TEF with severe RDS who require high pressure ventilation preoperatively represent a group of patients who require special consideration. The danger to such patients with increased pulmonary resistance is not gastric distention but sudden loss of intragastric pressure. In the presence of poor lung compliance, the upper gastrointestinal tract functions in continuity with the tracheobronchial tree. A sudden loss of intragastric pressure, as with placement of a gastrostomy tube, results in an acute loss of effective ventilating pressure. resuscitation of such a patient is not possible until leakage from the esophagus is controlled by ligation of the fistula or transabdominal occlusion of the distal esophagus. Placement of a Fogarty catheter into the fistula via a bronchoscope is effective but may not be feasible in every case. Early thoracotomy and ligation of the fistula in patients with progressive RDS provides immediate improvement in ventilatory efficiency and relief of gastric distention.- - - - - - - - - - ranking = 0.031717861655092keywords = atresia (Clic here for more details about this article) |
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