5. Fisula:
Is a permanent abnormal passageway
between two organs in the body or
between an organ and the exterior of
the body.
Normal Fistual
6. 1 case in 3000-4500
births.
the highest incidence of this disorder isin
Finland, where it is 1 case in 2500 births.
2% risk of recurrence is present
when a sibling is affected.
Increase in advanced maternalage.
7. At week 4 , the
Tracheabroncheal
diverticulum developed to
Tracheabroncheal sputum.
There is a failure to
separation in the sputum
leading to fistula.
During week 8, the primitive
gut failure to recanalization.
That lead to atrasia.
8.
9. Type A - Esophageal atresia without fistula or so-
called pure esophageal atresia (10%)
Type B - Esophageal atresia with proximal TEF (<
1%)
Type C - Esophageal atresia with distal TEF (85%)
Type D - Esophageal atresia with proximal and
distal TEFs (< 1%)
Type E - TEF without esophageal atresia or so-
called H-type fistula (4%)
Type F - Congenital esophageal stenosis (< 1%)
(This is not discussed in this article)
10. Currently, most authorities believe that the
development of esophageal atresia has a
nongenetic basis.
In a 1987 Kluth eschews has the concept that
esophageal vascular events, ischemic
events, or both may be causes in cases of
esophageal atresia without fistula.
In 2003, Spilde et al reported esophageal
atresia-TEF formations Adriamycin induced
teratogenesis.
15. A fetus with EA cannot
effectively swallow amniotic
fluid.
A fetus with esophageal atresia and a
distal TEF, amniotic fluid presumably
flows through the trachea and down
the fistula to the gut
Polyhydramnios premature labor
16. The neonate with EA cannot swallow and
there is copious amounts of saliva.
Aspiration of saliva or milk, if the baby is
allowed to suckle, can lead to an aspiration
pneumonitis.
17. In a baby with esophageal
atresia and a distal TEF, the
lungs may be exposed to
gastric secretions.
Also, air from the trachea can
pass down
when
the distal fistula
the baby
cries, strains, or receives
ventilation. This conditioncan
lead to an acute
which is
gastric
oftenperforation,
lethal.
20. Post-natal:
1.White, frothy bubbles of mucus in the
mouth and, sometimes, the nose.
2. Episodes of coughing, choking and cyanosis.
3.These episodes may be exaggerated during
feeding.
28. Preoperativemanagement:
1. The oral pharynx should be cleared.
2. The infant's head should be elevated.
3. IV fluids (10% dextrose in water).
4. Oxygen therapy is used.
5.In infants with respiratory failure,
endotracheal intubation should be
performed.
6.broad-spectrum antibiotics(such as
ampicillin plus gentamicin)
29. Surgical techniques vary
according to surgeons'
preferences and variations in
pathologic anatomy.
The best esophagus is thepatient's
esophagus.
30. Infants born with esophageal atresia
without fistula early gastrostomy
32. Infants born with esophageal atresia
with fistula early gastrostomy
33.
34. Roberta A Pagon, Editor-in-chief, Thomas D Bird, Cynthia R Dolan, Karen
Stephens, and Margaret P Adam, GeneReviews™, Seattle (WA): University
of Washington, Seattle; 1993.
Amulya K Saxena, Esophageal Atresia With or Without Tracheoesophageal
Fistula, Medscape. eMedicine, Updated: Apr 25, 2012, link:
(http://emedicine.medscape.com/article/935858-overview#showall )
DWAYNE C. CLARK, Esophageal Atresia and Tracheoesophageal Fistula,
1999 Feb 15;59(4):910-916.
Kronemer KA, Snyder-Warwick A. Esophageal
atresia/tracheoesophageal fistula. 2008. Available online
at eMedicine. Accessed 4-1-11.
