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oesophageal conditions.pptx
- 1. • Congenital conditions of the oesophagus • Laryngo-tracheal-oesophaeal clefts/Congenital tracheo-oesophageal fistula • Congenital oesophageal atresia • Congenital stricture • Congenital hiatus atresia • Dysphagia lusoria
- 2. • Congenital tracheo-oesophageal fistula • Laryngo-tracheo-oesophagial fistula results from the fusion failure of the lateral furrows that creates the tracheao-oesophageal septum during the 5th & 7th week • There are four types • Type –I fistula: or complete oesophageal atresia • Upper and lower oesophagus both end in blind pouches • Type-II fistula: the upper oesophageal end communicates with the trachea and the lower segment ends in a blind segment • Type-III fistula: the upper oesophageal ends in a blind segment and the lower segment communicates with the trachea
- 3. • Type-IV fistula: the upper oesophageal segment and the lower segment communicates with the trachea • Symptoms: • Seen immediately after birth • Infant has barking cough with choking and cyanosis which increases on feeding. Features of broncho- pneumonia due to aspirationare often present • Investigations: • Endoscopy • Treatment: • Stabilisation of respiratory function by either endotracheal intubation or tracheostomy • Definitive treatment: Surgical repair
- 4. • Traumatic conditions of the oesophagus • Burns & scalds • Trauma due to foreign bodies • Trauma due to external injuries • Symptoms: • Pain • Dysphagia • Features of shock • Investigations: • Endoscopy
- 5. • Neurological conditions of the oesophagus • Cricopharyngeal spasm • Achalasia cardia • Primary oesophageal motility disorder associated with the spasm of the lower oesophageal sphincter due to neuromuscular inco-ordination • Symptoms: • Affects males and females equally • Initial symptoms is retrosternal fullness • Dysphagia is a late symptom • Investigation: • Ba swallow • Endoscopy
- 6. • Treatment: • Smooth muscle relaxants : isosorbide dinitrite • & Ca channel blockers like verapramil, diltiazem • Surgical: • Balloon dilatation • Heller’s cardiomyotomy