HTF
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This document discusses the case of a 3-month-old female infant diagnosed with an H-type tracheoesophageal fistula (TEF). She presented with nasal regurgitation of feeds since 2 weeks of age and recurrent pneumonia. Investigations including barium swallow and bronchoscopy confirmed the diagnosis of H-type TEF. The infant underwent successful surgical ligation and repair of the fistula via a cervical approach. The document then provides details on the classification, embryology, diagnosis and management of TEFs.
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HTF
- 1. „H‟type Tracheo-esophageal Fistula SPEAKER- DR. VIJAYLAXMI SHRIVASTAVA DR. ASHWIN.A.JAISWAL MODERATOR- DR.M.K.MOHANTY DEPARTMENT OF PAEDIATRIC SURGERY J.L.N.H & R.C, BHILAI Dnbpaediatrics.blogspot.in
- 2. SIMMY 3 MONTHS/FEMALE NONCONSANGUINOUS MARRIAGE Dnbpaediatrics.blogspot.in
- 3. NASAL REGURGITATION OF FEEDS SINCE DAY 15 OF LIFE RECURRENT PNEUMONIA SINCE BIRTH CHOKING ON FEEDING Dnbpaediatrics.blogspot.in
- 4. HOSPITAL DELIVERY LSCS-MSAF VIGOROUS AT BIRTH BREAST FEEDING PHYSIOLOGICAL JAUNDICE Dnbpaediatrics.blogspot.in
- 5. NASAL & ORAL REGURGITATION OF FEEDS ON LYING SUPINE EVEN AFTER BURPING Dnbpaediatrics.blogspot.in
- 6. RECURRENT PNEUMONIA TREATED ON OPD BASIS FOR 10 DAYS ADMITTED FOR PNEUMONIA FOR 15 DAYS THRICE IN 3 DIFFERENT HOSPITALS Dnbpaediatrics.blogspot.in
- 7. REFERRED TO OUR HOSPITAL FOR NONRESOLUTION OF SYMPTOMS PEDIATRICIANS TREATED PNEUMONIA WITH ANTIBIOTICS Dnbpaediatrics.blogspot.in
- 8. Xray Dnbpaediatrics.blogspot.in
- 9. “DUE TO RECURRENCE OF PNEUMONIA POSSIBILITY OF GERD OR TRACHEOESOPHAGEAL FISTULA WAS SUSPECTED” Dnbpaediatrics.blogspot.in
- 10. CASE WAS DISCUSSED WITH PEDIATRIC SURGEON BARIUM MEAL DONE –GERD RULED OUT Dnbpaediatrics.blogspot.in
- 11. BRONCHOSCOPY DONE H-TYPE TRACHEOESOPHAGEAL FISTULA WAS CONFIRMED Dnbpaediatrics.blogspot.in
- 12. PREOPERATIVE MANAGEMENT PROPPED UP POSITION MINIMAL HANDLING PROKINETIC AGENTS THICK SMALL FEEDS PNEUMONIA WAS TREATED Dnbpaediatrics.blogspot.in
- 13. PLANNED FOR SURGERY PRIOR TO SURGERY PATIENT HAD PNEUMONIA TWICE EFFICIENTLY TREATED Dnbpaediatrics.blogspot.in
- 14. ESOPHAGEAL ATRESIA & TRACHEOESOPHAGEAL FISTULA COMMON LIFE-THREATENING MALFORMATIONS INCIDENCE OF 1 IN 3500 TO 1 IN 4500 BIRTH EQUAL SEX DISTRIBUTION / SLIGHT MALE PREPONDERANCE ASSOCIATED WITH CONGENITAL ANOMALIES (40-55%) Dnbpaediatrics.blogspot.in
- 15. Embryology Dnbpaediatrics.blogspot.in
- 16. Normal development of the Oesophagus and Trachea Dnbpaediatrics.blogspot.in
- 17. Gross-Vogt Classification Dnbpaediatrics.blogspot.in
- 18. Type A - EA without fistula / Pure EA(10%) Dnbpaediatrics.blogspot.in
- 19. Type B - EA with proximal TEF(<1%) Dnbpaediatrics.blogspot.in
- 20. Type C - EA with distal TEF (85%)
- 21. Type D -EA with proximal & distal TEF‟s(<1%) Dnbpaediatrics.blogspot.in
- 22. Type E - TEF without EA/ H-type fistula (4%) Dnbpaediatrics.blogspot.in
- 23. „H‟ TYPE TEF lamb ( 1873) Rare, isolated type of tef,4-5% m>f Level of fistula-2nd thoracic vertebra Dnbpaediatrics.blogspot.in
- 24. „H‟ TYPE TEF 70% occurs at /above the level of 2nd thoracic vertebra ( high as C7 and as low as T4) Types – „N‟ type & „H‟ type Oblique course –tracheal end cranially while esophagus caudally „N‟ type > „H‟ type Dnbpaediatrics.blogspot.in
- 25. „H‟ TYPE TEF Classical triad of symptoms Coughing & choking precipitated by feeds with or without cyanosis Recurrent lower respiratory tract infections Gaseous abdominal distension Dnbpaediatrics.blogspot.in
- 26. „H‟ TYPE TEF Excessive tracheal secretions with bubbly respirations Improvement of symptoms with gastric tube feedings Dnbpaediatrics.blogspot.in
- 27. „H‟ TYPE TEF Delayed diagnosis Least associated with congenital anomalies (25- 30%) Incidence of polyhydramnios is rare & lbw is less common Better prognosis Dnbpaediatrics.blogspot.in
- 28. DIAGNOSIS High clinical suspicion Cine esophagogram Rigid / Flexible Bronchoscopy CTscan /MRI / Radionuclide esophagogram Thoracoscopy Measurement of respiratory flow in esophageal lumen & o2 conc. in stomach Dnbpaediatrics.blogspot.in
- 29. BRONCHOSCOPY Dnbpaediatrics.blogspot.in
- 30. Surgical Management Bronchoscopic repair cauterization tissue adhesives application Ligation & repair of the TEF by cervical approach Thoracoscopic repair Repair of fistula by thoracotomy approach Nd-YAG laser coagulation Dnbpaediatrics.blogspot.in
- 31. Surgical Management LIGATION & REPAIR OF FISTULA BY CERVICAL APPROACH Dnbpaediatrics.blogspot.in
- 32. Anaesthesia Dnbpaediatrics.blogspot.in
- 33. Position Dnbpaediatrics.blogspot.in
- 34. Incision & Approach Dnbpaediatrics.blogspot.in
- 35. Identification of Trachea & Oesophagus Dnbpaediatrics.blogspot.in
- 36. Identification of fistula Dnbpaediatrics.blogspot.in
- 37. Ligation of fistula at Tracheal & Oesophageal end Dnbpaediatrics.blogspot.in
- 38. Repair of fistula with meticulous closure of Tracheal & Oesophageal end Dnbpaediatrics.blogspot.in
- 39. Post op investigations Gastrograffin study Dnbpaediatrics.blogspot.in
- 40. Healed Neck wound HAPPY BABY Dnbpaediatrics.blogspot.in
- 41. TEAM APPROACH PAEDIATRIC SURGEON PAEDIATRICIAN EXPERIENCED TRAINED ENT SURGEON ANAESTHETIST Dnbpaediatrics.blogspot.in