Bilious vomiting in Tracheo-oesophageal fistula with oesophageal atresia, Situs Inversus incompletus and gastro-biliary fistula. A diagnostic conundrum
Publication date: Available online 14 November 2019Source: Journal of Pediatric Surgery Case ReportsAuthor(s): Oluwaseun A. Ladipo-Ajayi, Olukayode O. Olayade, Adesoji Ademuyiwa, Ozor Ifezue, Kasiemobi UchimeAbstractThe diagnosis of oesophageal atresia with or without fistula has traditionally been premised on the clinical finding of excessive salivation, regurgitation of feeds with attendant respiratory compromise in affected neonates. In addition, inability to pass an appropriate sized oesophageal tube into the stomach is confirmatory. OA/TOF is documented to be associated with other congenital abnormalities in up to 50% of cases. These often affect the outcome of treatment. A presentation of OA/TOF with bilious vomiting is rare and requires a high index of suspicion and appropriately selected investigations to cinch the diagnosis. Thus bilious vomiting in a neonate does not rule out the diagnosis of OA/TOF and it is important to ensure a thorough examination and investigation in every surgical neonate.
Condition: Esophageal Atresia With Tracheoesophageal Fistula Intervention: Diagnostic Test: high resolution impedance manometry Sponsors: Great Ormond Street Hospital for Children NHS Foundation Trust; National Institute for Health Research, United Kingdom Not yet recruiting
Congenital TEFs without esophageal atresia are rare but may occur more frequently than previously documented in literature. Careful history is required to suspect the diagnoses, as most patients will present with coughing associated with solid or liquids, recurrent unexplained pulmonary infections and complaints with eating. Some patients may show signs of chronic airway changes from recurrent aspiration pneumonia at the time of presentation. Diagnosis is challenging, with multiple imaging modalities including x ray, CT scan and esophogram able to identify a fistula.
Conclusion Participants of the first ERNICA conference reached significant consensus on the follow-up of patients with EA/TEF who undergo primary anastomosis. Fundamental statements regarding centralization, multidisciplinary approach, and involvement of patient organizations were formulated. These consensus statements will provide the cornerstone for uniform treatment protocols and resultant optimized patient care. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Abstract | Full text
Conclusion: Using a sling of the linea alba around the cardioesophageal junction, prevents gastroesophageal reflux and escape of air from esophagus into the stomach, gives time to improve the respiratory and nutritional status of the patient, for a subsequent safer delayed primary anastomosis.
Meera Luthra, Chiranjiv Kumar, Sanjay Saran BaijalJournal of Indian Association of Pediatric Surgeons 2020 25(1):43-45 Choledocholithiasis (CDL) in neonates and infants is <1 in 5000. There is no gold standard for the management of CDL in the pediatric population. In English literature, this is the first case report of a baby born with esophageal atresia and tracheoesophageal fistula (Type C) with cholangitis, who underwent percutaneous transhepatic biliary drainage and peroral extraction of a large calculus in the common bile duct after primary repair of esophagus.
Esophageal atresia with or without a tracheo-esophageal fistula is a challenging anomaly in neonates. Thoracoscopic repair is gaining popularity now in pediatric surgery community. The present study aims at comparing the short term outcomes of thoracoscopy versus classic thoracotomy for repair of such conditions.
Conclusions: this is the largest study in pediatric NCFB. As the management of NCFB affected patients remains problematic, a better definition of clinical, radiological and microbiological features of NCFB is required to improve their management.Reference:1. BMC Pediatrics 2014;14: 299
AbstractObjectiveTracheo-oesophageal fistula (TOF) is a rare pathology. It can be congenital and concurrent with other congenital anomalies such as oesophageal atresia, laryngeal and tracheal agenesis, or it can be acquired. The purpose of this study was to analyse various management strategies and their outcomes in infants and children with TOF and identify potential areas for standardisation of the fistula repair procedures.MethodsAt a single institution, a retrospective analysis of infants and children with congenital or acquired TOF between 2013 and 2019 was performed. Thirteen patients were identified. Data collection...
We describe a technical modification to approach for dissection of proximal pouch in patients undergoing the primary repair of congenital Esophageal atresia with tracheoesophageal fistula (EA-TEF).
Objectives: The aim of the study was to evaluate acid and nonacid gastroesophageal reflux in infants and school-aged children with esophageal atresia (EA) using pH-impedance (pH-MII) monitoring. Methods: Between 2012 and 2017, all 24-hour pH-MII studies performed in infants (≤18 months) and 8-year olds with EA were included. Antiacid therapy was discontinued before study. Exclusion criteria were: isolated tracheoesophageal fistula; esophageal replacement therapy; tube feeding; and monitoring