1/9. 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 = physician (Clic here for more details about this article) |
2/9. Perforation of the posterior tracheal wall during percutaneous dilatational tracheotomy.Dilatative percutaneous tracheotomy is more and more indicated in intensive-care medicine. We report on the perforation of the posterior tracheal wall observed in 3 patients after this procedure. In 2 patients the tracheo-oesophageal fistula was closed by the use of a pediculated flap from the infrahyoideal muscle. The third patient died due to the underlying disease. As demonstrated by the 3 cases reported here, this complication cannot be avoided in every case neither by the use of an endoscope nor by extensive personal experience of the physician. The possibility of this complication should be known, because it seems to be typical of this procedure. In the case of perforation of the posterior tracheal wall, active surgical treatment seems to be a successful method to deal with this complication.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/9. tracheoesophageal fistula and massive pneumoperitoneum after prolonged mechanical ventilation.We describe a patient who had two unusual complications of prolonged mechanical ventilation-tracheoesophageal fistula and pneumoperitoneum-with a fatal outcome. Recurrent pulmonary aspirations and massive abdominal distention in the setting of longstanding artificial ventilation should alert the physician to these possibilities.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/9. VATER association.Baby S began oral feedings on day 8 at 20 ml/kg/day. The infant reached full enteral feedings on day 11 and was subsequently advanced to an ad lib demand schedule. The broviac catheter was removed on day 13. An orthopedic surgeon was consulted to evaluate abnormalities of the upper extremities and hip laxity noted on admission examination. The orthopedic specialist found decreased abduction of the hips bilaterally with no instability and normal range of motion on exam. An ultrasound showed bilateral posterior subluxation with no frank dislocation. The infant was evaluated by a physical therapist and received daily splinting and stretching of the upper extremities, with continued evaluation planned following discharge. When the infant was discharged on day 15, she was breastfeeding on a demand schedule with bottle supplementation and continued to receive ranitidine and metoclopramide. Follow-up was scheduled with the cardiologist, the orthopedic surgeon, and the family physician.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/9. Tracheal atresia as part of an exceptional combination of malformations.A case of a premature infant with tracheal atresia together with an exceptional combination of congenital abnormalities that partially corresponds to the TACRD and VACTERL associations is presented. Tracheal atresia was not detectable in the prenatal ultrasound due to lacking of the typical diaphragmatic and pulmonary findings because of the esophago-tracheal fistula, and therefore the resuscitation team was not prepared for this severe airway complication. After prolonged resuscitation efforts were terminated and the newborn expired after birth. Even without typical warning signs physicians have to be aware of tracheal atresia and airway obstruction if VACTERL or TACRD associations are diagnosed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/9. Massive gastric distention in the intubated patient. A marker for a defective airway.Tracheal intubation is a commonly performed procedure generally associated with a low complication rate. A clinical sign that could lead to early detection of complications could improve management of mechanically ventilated patients. We present two instances of potentially lethal complications that were heralded by the presence of massive gastric distention. This finding should alert physicians that an abnormal communication may exist between the endotracheal tube and the gastrointestinal tract.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/9. esophageal atresia and tracheoesophageal fistula.Associated anomalies are now the major cause of mortality in infants with esophageal atresia. early diagnosis, preoperative management and appropriate referral for repair are challenges for the family physician. Timing and choice of surgical procedure depend on the type of malformation.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/9. Simultaneous Bochdalek hernia and type C tracheoesophageal fistula.The occurrence in an infant of coexisting congenital diaphragmatic hernia, proximal esophageal atresia, and distal tracheoesophageal fistula is extremely rare, and the literature contains only anecdotal reports of treatment. Because these infants often have challenging clinical presentations and may deteriorate rapidly, physicians should be aware of manifestations of this combination of conditions and how to manage them.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/9. esophageal perforation caused by coin ingestion.esophageal perforation and acquired tracheoesophageal fistulae (ATEF) are rare sequelae of foreign body ingestion in the pediatric population. Here we discuss the cases of two patients with esophageal perforation caused by prolonged impaction of a coin; in one case, a tracheoesophageal fistula developed. The presence of aerodigestive symptoms and signs in infants and small children should prompt physicians to consider foreign body ingestion and the presence of an ATEF. Clinical presentation, diagnostic modalities, and technical considerations for surgical management are outlined.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |