الفهرس | Only 14 pages are availabe for public view |
Abstract Improvements in fetal imaging have led to increased prenatal diagnosis of this condition. Prenatal ultrasound findings include a small or absent stomach bubble and polyhydramnios. After birth, patients with Esophageal Atresia and distal fistula typically present with excessive salivation and regurgitation with feeds, respiratory distress, and an inability to pass an nasogastric tube. Plain films demonstrate a nasogastric tube coiled in the upper esophageal pouch. Air in the stomach and distal bowel confirms the presence of a distal fistula. For H-type fistulas, patients usually choke with feeds or have cyanotic spells. Older infants may present with recurrent pneumonia. In isolated TEF, chest x-rays may show pneumonitis and gastric distension. Generally, the operative correction of an oesophageal atresia and tracheoesophageal fistula is not regarded as an emergency procedure. The only exception is the preterm infant with severe respiratory distress syndrome requiring ventilatory support. . In most infants, open thoracotomy or thoracoscopic division of the fistula with primary anastomosis of the esophagus is possible. |