scholarly journals Post-esophageal atresia repair double acquired tracheoesophageal fistulas treated successfully by gastric transposition: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Nobuhiro Takahashi ◽  
Yasushi Fuchimoto ◽  
Teizaburo Mori ◽  
Kiyotomo Abe ◽  
Yohei Yamada ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Anastomotic Stricture ◽  
Balloon Dilation ◽  
Lower Lobe ◽  
Oral Intake ◽  
Postoperative Recurrence ◽  
Lobe Bronchus ◽  
Gastric Transposition ◽  
The Right

Abstract Background Postoperative recurrence of tracheoesophageal fistula (TEF) is a frequent complication in the repair of esophageal atresia (EA). Based on the recent etiologic classification, a TEF that develops in a different new pathway from the original one is categorized as an acquired TEF. The TEFs that fall into this category have been reported to be refractory and their mechanisms have not been fully understood. Here, we report the complicated case of an acquired TEF derived from mediastinitis after the original TEF repair developed an anastomotic stricture. The TEF contained double fistulas, both towards the right lobe bronchi, and was repaired by gastric transposition through a retrosternal route. Case presentation The patient was diagnosed with Gross C esophageal atresia after birth and underwent tracheoesophageal fistula banding during the neonatal period. He experienced an intractable anastomotic stenosis after surgery which was treated with repeated balloon dilation therapy. By the age of 11 months, he developed a mediastinal abscess that improved with conservative treatment. At 18 months old, a fistula from the esophagus to the right superior lobe bronchus was identified. The patient underwent a right upper lobectomy to resect the fistula. However, at 21 months old, another fistula to the right lower lobe was revealed. An esophageal banding was done to relieve the respiratory symptoms. This was followed by esophagectomy and gastric transposition through the retrosternal route at 26 months old. The patient started rehabilitation and oral intake gradually after surgery. By 3 years after gastric transposition, he could already take blended food orally with the support of small amounts of enteral feeding. Conclusion Cases of TEF derived from severe inflammation have the potential to form a complicated network and lead to recurrence. Surgeons should consider the possibility of multiple tiny fistulas in cases of severe acquired TEF. These may be repaired successfully by gastric transposition through the retrosternal route.

scholarly journals Esophageal atresia and situs inversus - an unusual association of abnormalities - a case report

2006 ◽  
Vol 59 (1-2) ◽  
pp. 73-78 ◽  
Author(s):  
Svetlana Bukarica ◽  
Smiljana Marinkovic ◽  
Vladimir Borisev ◽  
Jelena Antic
Keyword(s):  
Case Report ◽  
Esophageal Atresia ◽  
Situs Inversus ◽  
Tracheoesophageal Fistula ◽  
Anastomotic Stricture ◽  
Orogastric Tube ◽  
Abdominal Organs ◽  
One Year ◽  
The Right ◽  
Thoracic And Abdominal

We present a case report of a neonate with esophageal atresia and tracheoesophageal fistula. In the 31st week of gestation, maternal polyhydramnions was observed by prenatal ultrasonography. Postnatal insertion of an orogastric tube into the stomach was unsuccessful. On auscultation, the apex of the heart was heard at the right side of the thorax, while the liver was palpable I cm below the left rib cage. Esophageal atresia with tracheoesphageal fistula and situs inversus of the thoracic and abdominal organs was diagnosed. During the first day of life, left transpleural thoracotomy was performed. The fistula was closed and esophageal anastomosis performed. One year after the operation the child had no difficulties when eating solid and liquid foods. More than 50% of infants with esophageal atresia have associated anomalies and the esophagogram showed good passage of contrast with anastomotic stricture. This was the first report of esophageal atresia with tracheoesophageal fistula repair in a patient with situs inversus treated in our Clinic. .

scholarly journals Endoscopic Stenting and Clipping for Anastomotic Stricture and Persistent Tracheoesophageal Fistula after Surgical Repair of Esophageal Atresia in an Infant

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Mohammed Amine Benatta ◽  
Amine Benaired ◽  
Ahmed Khelifaoui
Keyword(s):  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Surgical Repair ◽  
Anastomotic Stricture ◽  
Balloon Dilation ◽  
Endoscopic Stenting ◽  
Recurrent Fistula ◽  
Metal Type ◽  
Esophageal Strictures

Anastomotic stricture (AS) and recurrent tracheoesophageal fistula (TEF) are two complications of surgical repair of esophageal atresia (EA). Therapeutic endoscopic modalities include stenting, tissue glue, and clipping for TEF and endoscopic balloon dilation bougienage and stenting for esophageal strictures. We report herein a two-month infant with both EA and TEF who benefited from a surgical repair for EA, at the third day of life. Two months later he experienced deglutition disorders and recurrent chest infections. The esophagogram showed an AS and a TEF confirmed with blue methylene test at bronchoscopy. A partially covered self-expanding metal type biliary was endoscopically placed. Ten weeks later the stent was removed. This allows for easy passage of the endoscope in the gastric cavity but a persistent recurrent fistula was noted. Instillation of contrast demonstrated a fully dilated stricture but with a persistent TEF. Then we proceeded to placement of several endoclips at the fistula site. The esophagogram confirmed the TEF was obliterated. At 12 months of follow-up, he was asymptomatic. Stenting was effective to alleviate the stricture but failed to treat the TEF. At our knowledge this is the second case of successful use of endoclips placement to obliterate recurrent TEF after surgical repair of EA in children.

scholarly journals Auscultating a pea: the stethoscope may matter in otorhinolaryngology emergency evaluation

2021 ◽  
Vol 7 (3) ◽  
pp. 530
Author(s):  
Francisco Alves De Sousa ◽  
Ana Costa Silva ◽  
Ana Nóbrega Pinto ◽  
Cecília Almeida E. Sousa
Keyword(s):  
Foreign Body ◽  
Lower Lobe ◽  
Signs And Symptoms ◽  
Foreign Body Sensation ◽  
Careful Examination ◽  
Lower Airway ◽  
Lobe Bronchus ◽  
Body Sensation ◽  
The Right

<p>Foreign body sensation is a common complaint in the otorhinolaryngology emergency. Careful examination of the patient’s pharynx is mandatory, but sometimes the object is not visualized. In such scenario, it may be important to explore signs and symptoms indicating lower aerodigestive impaction. This work describes the case of a 73-year-old woman without relevant comorbidities attending to emergency care. She complained of a foreign body sensation on the right side of the throat after ingesting a meal, which motivated referral to otorhinolaryngology. Flexible transnasal nasopharyngoscopy was unremarkable and no foreign bodies were found. Auscultation was performed revealing low-pitch expiratory wheezing on her right hemithorax. The suspicion of bronchial foreign body was then raised, which was ultimately confirmed by imaging and bronchoscopy, showing an impacted pea on the right lower lobe bronchus. The stethoscope was hence determinant for detecting aspiration, by revealing consistent alterations. Its usage should be encouraged in similar scenarios, highlighting the role of this classic but sometimes forgotten tool. Importantly, higher neck/throat sensations should not exclude the possibility of a lower airway foreign body.</p>

Effect of Swallowing Rehabilitation Protocol on Swallowing Function in Patients with Esophageal Atresia and/or Tracheoesophageal Fistula

2017 ◽  
Vol 27 (06) ◽  
pp. 526-532 ◽  
Author(s):  
Selen Serel Arslan ◽  
Numan Demir ◽  
Sule Yalcın ◽  
Ayşe Karaduman ◽  
Ibrahim Karnak ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Oral Intake ◽  
Control Group ◽  
Study Group ◽  
Start Time ◽  
Swallowing Function ◽  
Rehabilitation Protocol ◽  
Swallowing Rehabilitation ◽  
Pharyngeal Swallowing

Aim The aim of this study was to evaluate the results of Swallowing Rehabilitation Protocol (SRP) on swallowing function (SF) of esophageal atresia and tracheoesophageal fistula (EA-TEF) patients with pharyngeal swallowing disorder. Materials and Methods In this study, 24 children with EA-TEF who had deglutitive and respiratory problems were grouped into either study (n = 12) or control group (n = 12) by basic randomization. Study group received the SRP including neuromuscular electrical stimulation, thermal tactile stimulation, and hyolaryngeal mobilization. The control group received nonnutritive stimulations. SF was evaluated with 3 mL liquid and pudding barium by videofluoroscopic swallowing study (VFSS) before and after 20 sessions of interventions. Results No statistical differences were found between groups in terms of descriptive characteristics including age, sex, weight, height, type of atresia, repair type, repair time, and start time of oral intake (p > 0.05). There were no statistical differences between groups in term of swallowing parameters (p > 0.05), except reflux (p = 0.004) according to VFSS findings. After 20 sessions of interventions, the study group showed improvement in penetration–aspiration scale scores, oral phase dysfunction, delay in swallowing reflex, and residue in valleculae and pyriform sinuses after pudding swallow. The control group showed improvement only in oral phase dysfunction. Conclusion SRP can be recommended to improve SF in patients with EA/TEF who have pharyngeal swallowing disorders.

Coarctation of persistent right fifth aortic arch and pulmonary sequestration

1998 ◽  
Vol 8 (4) ◽  
pp. 509-511 ◽  
Author(s):  
Hideshi Tomita ◽  
Shigeto Fuse ◽  
Shunzo Chiba
Keyword(s):  
Heart Failure ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Balloon Dilation ◽  
Lower Lobe ◽  
Pressure Overload ◽  
Pulmonary Sequestration ◽  
Severe Congestive Heart Failure ◽  
Volume Load ◽  
The Right

AbstractA 41-day-old boy was transferred to our department with severe congestive heart failure. Digital subtraction counter current aortography, and antegrade aortography, revealed coarctation of a persistent right fifth aortic arch, stenosis of the origin of an aberrant left subclavian artery, and sequestration of the lower lobe of the right lung.As his heart failure seemed to be caused not only by pressure overload to the left ventricle following coarctation, but also by the volume load associated with the shunting effect of the pulmonary sequestration, we performed transcatheter balloon dilation of the coarctation and the origin of the aberrant subclavian artery, together with embolization of the aberrant pulmonary artery. His heart failure responded dramatically to these procedures.

scholarly journals Clinical Comparison Between Thoracoscopic and Thoracotomy Repair of Gross Type C Esophageal Atresia

2021 ◽  
Author(s):  
Shen Yang ◽  
Peize Wang ◽  
Zhi Yang ◽  
Siqi Li ◽  
Junmin Liao ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Anastomotic Leakage ◽  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Operative Time ◽  
Anastomotic Stricture ◽  
Surgical Approaches ◽  
Invasive Technique ◽  
Thoracoscopic Approach ◽  
Type C

Abstract Background To compare the clinical outcomes between thoracoscopic approach and thoracotomy surgery in patients with Gross type C Esophageal atresia (EA) and tracheoesophageal fistula (TEF). Methods Patients with Gross type C EA/TEF who underwent surgery from January 2007 to January 2020 at Beijing Children’s Hospital were retrospectively analyzed. The patients were divided into 2 groups according to surgical approaches. The perioperative factors and postoperative complications were compared among the 2 groups. Results One hundred and ninety patients (132 boys and 58 girls) with a median birth weight of 2975 (2600, 3200) g were included. The primary operations were performed via thoracoscopic (n = 62) and thoracotomy (n = 128) approach. After comparison of clinical characteristics between the 2 groups, we found that there were statistically significant differences in associated anomalies, method of fistula closure, duration of mechanical ventilation after surgery, feeding option before discharge, management of pneumothorax, and prognosis (all P < 0.05). To a certain extent, thoracoscopic surgery reduced the incidence of anastomotic leakage and increased the incidence of anastomotic stricture in this study. However, there were no statistically significant differences between the 2 groups in terms of operative time, postoperative pneumothorax, anastomotic leakage, anastomotic stricture, and recurrent tracheoesophageal fistula (all P > 0.05). Conclusions Thoracoscopy surgery for Gross type C EA/TEF is a safe and effective, minimally invasive technique with comparable operative time and incidence of postoperative complications.

Anastomotic stricture indexes for endoscopic balloon dilation after esophageal atresia repair: a single-center study

2020 ◽  
Author(s):  
Jinshi Huang ◽  
Junmin Liao ◽  
Shen Yang ◽  
Yanan Zhang ◽  
Yong Zhao ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Roc Curve ◽  
Balloon Dilatation ◽  
Anastomotic Stricture ◽  
Balloon Dilation ◽  
Curve Analysis ◽  
Medium Term ◽  
Roc Curve Analysis ◽  
Endoscopic Balloon Dilatation ◽  
Endoscopic Balloon

Summary We investigated changes in anastomotic stricture indexes (SIs) and stricture diameter (SD) between before and 6 months after the first dilatation in children with anastomotic stricture after esophageal atresia (EA) repair and identified predictors of medium-term dilatation success (success for at least 3 months). We retrospectively reviewed the records and measurement indexes of patients who underwent post-EA repair endoscopic balloon dilatation between November 2017 and August 2019 in our hospital. We identified diagnostic and performance indicators that predicted medium-term dilatation success by univariate and multivariate analyses and receiver operator characteristic (ROC) curve analysis. Sixty patients (34 boys and 26 girls) showed post-EA repair anastomotic stricture. Paired sample t-tests showed that SD (P &lt; 0.001), upper pouch SI (U-SI, P &lt; 0.001), lower pouch SI (L-SI, P &lt; 0.001), upper pouch esophageal anastomotic SI (U-EASI, P &lt; 0.001) and lower pouch EASI (L-EASI, P &lt; 0.001) were significantly better at 6 months after than before the first dilatation. Logistic regression analysis showed that dilatation number (P = 0.002) and U-SI at 6 months after the first dilatation (P = 0.019) significantly predicted medium-term dilatation success. ROC curve analysis revealed that combining U-SI (cut-off value = 55.6%) and dilatation number (cut-off value = 10) had good accuracy in predicting medium-term dilatation success 6 months after the first dilatation (area under the curve-ROC: 0.95). In conclusion, endoscopic balloon dilatation significantly improved SD and SIs in children with post-EA repair anastomotic stricture. Dilatation number and U-SI at 6 months after the first dilatation were useful in predicting medium-term dilatation success and could represent a supplementary method to improve judgment regarding whether further dilatation is needed 6 months after the first dilatation.

scholarly journals Primary Epithelial Myoepithelial Carcinoma of Lung, Reporting of a Rare Entity, Its Molecular Histogenesis and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Farzana Arif ◽  
Susan Wu ◽  
Shahriyour Andaz ◽  
Stewart Fox
Keyword(s):  
Incidental Finding ◽  
Lower Lobe ◽  
Final Diagnosis ◽  
Myoepithelial Cells ◽  
Myoepithelial Carcinoma ◽  
Rare Entity ◽  
Lobe Bronchus ◽  
Epithelial Myoepithelial Carcinoma ◽  
Bronchial Glands ◽  
The Right

Primary epithelial myoepithelial carcinoma of lung is a rare entity and is thought to arise from the submucosal bronchial glands distributed throughout the lower respiratory tract. Because of the rarity of this tumor, we describe one case of epithelial myoepithelial carcinoma arising in the bronchus intermedius and presenting as an endobronchial mass. A 57-year-old male patient presented with an incidental finding of an endobronchial mass located in the lumen of the right lower lobe bronchus and caused near total luminal occlusion of the bronchus. An endobronchial carcinoid tumor was entertained clinically. Subsequently the patient underwent an uneventful videothoracoscopic lobectomy of lower and middle lobes of the right lung. Morphologically and immunohistochemically the tumor was characterized by two cell populations with epithelial and myoepithelial cells forming duct-like structure. The final diagnosis of epithelial myoepithelial carcinoma of lung was rendered.

scholarly journals LONG-TERM STAY OF METALLIC FOREIGN BODIES IN THE BRONCHI

2018 ◽  
Vol 22 (5) ◽  
pp. 275-276
Author(s):  
Aitbay A. Gumerov ◽  
V. A. Paramonov ◽  
R. R. Zainullin ◽  
R. A. Gumerov ◽  
E. S. Semenova ◽  
...  
Keyword(s):  
Foreign Bodies ◽  
Lower Lobe ◽  
The Other ◽  
Preoperative Preparation ◽  
Lobe Bronchus ◽  
Clinical Observations ◽  
First Child ◽  
Lobar Bronchus ◽  
The Right

The article presents two clinical observations of the stay of metallic foreign bodies in the bronchi. In the first child, a needle pushpin with a plastic casing was for 2 years in the lumen of the lower lobe bronchus on the right, while in the other case the screw stayed also in the right lower lobe bronchus for two weeks. Removal of foreign bodies of bronchi is performed urgently after the appropriate preoperative preparation in the operating room. Removal of the foreign body was carried out with pronounced technical difficulties, after repeated attempts for an hour. There were no complications during and after manipulation. Bronchoscopy revealed narrowing of the lumen of the lower lobar bronchus, edema, and hyperemia of the mucous membrane, as well as granulation tissue, partially overlapping the clearance of the bronchus.

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