1/429. esophageal atresia and tracheoesophageal fistula.esophageal atresia, with or without tracheoesophageal fistula, is a fairly common congenital disorder that family physicians should consider in the differential diagnosis of a neonate who develops feeding difficulties and respiratory distress in the first few days of life. esophageal atresia is often associated with other congenital anomalies, most commonly cardiac abnormalities such as ventricular septal defect, patent ductus arteriosus or tetralogy of fallot. Prompt recognition, appropriate clinical management to prevent aspiration, and swift referral to an appropriate tertiary care center have resulted in a significant improvement in the rates of morbidity and mortality in these infants over the past 50 years.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
2/429. tracheoesophageal fistula caused by a self-expanding esophageal stent.A patient is presented who had previously undergone an esophagectomy for an adenocarcinoma of distal esophagus. He experienced repeated strictures at the esophagogastric anastomosis at 22 cm. After multiple dilatations, a self-expanding metal stent was placed. Four months later the upper edge of the stent eroded through the esophagus into the trachea, forming a tracheoesophageal fistula. Muscle flap repair was successful.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
3/429. anesthesia for insertion of a Dumon stent in a patient with a large tracheo-esophageal fistula.PURPOSE: To present the anesthetic management for the insertion of a Dumon silicon stent to the trachea of a patient with a large tracheo-esophageal fistula. The aim of the stent insertion was to seal the fistula in order to prevent aspiration of esophageal content and subsequent pneumonitis. CLINICAL FEATURES: A 45-yr-old man with a large tracheo-esophageal fistula was scheduled for the insertion of the Dumon stent. Since placement of the stent necessitates the insertion of a rigid bronchoscope, under general anesthesia, with its tip just proximal to the fistula, controlled ventilation was expected to be difficult to achieve because of the diversion of oxygen through the large fistula to the esophagus. We successfully ventilated the lungs, after the fistula was sealed using a large balloon which was inserted in the esophagus, and the stent insertion was completed uneventfully. CONCLUSION: anesthesia for procedures involving the central airway is challenging. This report describes a simple and practical method to facilitate ventilation by temporary seal of a tracheo-esophageal fistula using a modified esophageal balloon.- - - - - - - - - - ranking = 2.2keywords = fistula (Clic here for more details about this article) |
4/429. Esophageal lung with multiple congenital anomalies: conundrums in diagnosis and management.BACKGROUND/PURPOSE: Communicating bronchopulmonary foregut malformations (CBPFM) are a diverse group of potentially devastating congenital anomalies with anatomy that may be difficult to delineate. The authors present a case that illustrates conundrums in the diagnosis and management of these complex disorders. methods: A term baby had esophageal atresia (EA), tracheoesophageal fistula (TEF), and tetralogy of fallot. Initially, a gastrostomy was performed, and a balloon catheter was inserted through the endotracheal tube to occlude the fistula until the patient was hemodynamically stable. Subsequently, the fistula was ligated. Postoperatively, the left lung collapsed, and bronchoscopy showed an atretic left mainstem bronchus. Repeat thoracotomy showed that the fistula ligation was intact. air was introduced through the gastrostomy tube, and, surprisingly, the left lung inflated, indicating the left mainstem bronchus arose from the esophagus distal to the ligated TEF. RESULTS: Despite reopening this fistula, ventilation remained poor, and support was withdrawn. autopsy findings confirmed a unilobed left lung arising from the esophagus, EA, TEF, an atretic left mainstem bronchus, tetralogy of fallot, and digeorge syndrome. CONCLUSIONS: This is the first report of a combination of EA and distal TEF with a second CBPFM involving the esophagus and the entire left lung. Successful correction of these anomalies will require extensive delineation of the anatomy to plan an operative strategy.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
5/429. Congenital cystic adenomatoid malformation of the lung associated with esophageal atresia and tracheoesophageal fistula.Bronchopulmonary malformations associated with esophageal atresia (EA) and tracheoesophageal fistula (TEF) are extremely rare. The authors describe a case of type II congenital cystic adenomatoid malformation (CCAM) of the right lower lobe associated with EA and TEF (Vogt-Gross type C) in a full-term female infant. The CCAM presented as an incidental radiologic finding, and a contralateral tension pneumothorax developed shortly after surgical repair of the EA. Early recognition of this rare association is essential for correct operative management.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
6/429. Successful long-term endoscopic closure of a recurrent tracheoesophageal fistula with fibrin glue in a child.We present an unusual case of recurrent tracheoesophageal fistula after primary surgical repair of congenital esophageal atresia. Traditionally, this disorder has required open-surgical correction, but successful endoscopic closure of these fistulas has been reported. This case report describes our experience using fibrin glue, applied endoscopically in a 6-year-old child, with encouraging long-term results 4 years after treatment.- - - - - - - - - - ranking = 1.2keywords = fistula (Clic here for more details about this article) |
7/429. Novel use of neonatal cuffed tracheal tube to occlude tracheo-oesophageal fistula.The use of a cuffed tracheal tube is described to occlude the leak through a tracheo-oesophageal fistula (TOF) in a neonate and prevent gastric dilatation during positive-pressure lung ventilation.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
8/429. A novel intubation technique for tracheoesophageal fistula in adults.PURPOSE: To describe a novel technique of tracheal intubation and ventilation in an adult patient with a large tracheoesophageal fistula at the level of the carina. CLINICAL FEATURES: A 59 yr old woman with squamous cell carcinoma of the esophagus developed a large (2 cm diameter) tracheoesophageal fistula after radiotherapy. The level of her fistula precluded traditional use of a double-lumen endobronchial tube. intubation and ventilation were managed with two endobronchial tubes. The ability to ventilate or collapse each lung individually was preserved and anesthesia and surgery proceeded uneventfully. CONCLUSION: Double endobronchial intubation is described to manage anesthesia in an adult patient with a tracheoesophageal fistula at the level of the carina.- - - - - - - - - - ranking = 1.6keywords = fistula (Clic here for more details about this article) |
9/429. Use of a Palmaz stent for tracheomalacia: case report of an infant with esophageal atresia.A male infant with congenital cardiac anomalies and esophageal atresia with tracheoesophageal fistula (EA-TEF) showed intractable respiratory symptoms after delayed primary repair of EA-TEF. Computed tomography demonstrated that the trachea was compressed by the enlarged aorta. Artificial ventilation was necessary even after aortopexy performed at 2 months of age. At 140 days of age, an expandable metallic stent (Palmaz stent) was inserted through a rigid bronchoscope into the trachea underfluoroscopic control. His respiratory status improved dramatically, and he was extubated in 18 hours. Although the follow-up period has been 9 months, the short-term result is satisfactory. The expandable metallic stent placement should be considered in patients with EA-TEF who show intractable respiratory symptoms caused by tracheomalacia.- - - - - - - - - - ranking = 0.2keywords = fistula (Clic here for more details about this article) |
10/429. Gastric tube-to-tracheal fistula closed with a latissimus dorsi myocutaneous flap.A gastric tube-to-airway fistula is a very rare complication after esophageal reconstruction. A patient with a gastric tube-to-tracheal fistula that developed more than 9 years after surgery for cancer of the cervical esophagus was treated with transposition of a pedicled latissimus dorsi myocutaneous flap. Careful perioperative respiratory management helped save the patient's life.- - - - - - - - - - ranking = 1.2keywords = fistula (Clic here for more details about this article) |
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