Makhoul I, Bar-Maor J A
Dept. of Pediatric Surgery, Rambam Medical Center, Haifa.
Harefuah. 1992 Jan 1;122(1):19-20.
Esophageal atresia is a congenital malformation present in 1 in 4500 live births. 85% of such newborns also have a fistula connecting the distal esophagus with the trachea. Operative management includes closing the fistula by disconnecting the distal esophagus from the trachea and performing end-to-end esophago-esophageal anastomosis. A late complication is a recurrence of the fistula between esophagus and respiratory tract. The recurrent fistula is usually between the esophagus and the trachea, but it may involve the bronchi or lung tissue. This complication causes significant respiratory morbidity, mainly recurrent pneumonia, and sometimes death. The diagnosis of recurrent fistula is usually by barium swallow and/or esphagobronchoscopy. Repair is a surgical challenge. We report 5 infants with recurrent esophago-respiratory tract fistulas out of a total of 68 cases of esophageal atresia with tracheo-bronchial fistula.
食管闭锁是一种先天性畸形,在每4500例活产儿中出现1例。85%的此类新生儿还存在将远端食管与气管相连的瘘管。手术治疗包括通过将远端食管与气管分离来闭合瘘管,并进行端端食管-食管吻合术。一种晚期并发症是食管与呼吸道之间瘘管复发。复发性瘘管通常发生在食管与气管之间,但也可能累及支气管或肺组织。这种并发症会导致严重的呼吸道疾病,主要是反复肺炎,有时还会导致死亡。复发性瘘管的诊断通常通过吞咽钡剂和/或食管支气管镜检查。修复手术具有挑战性。我们报告了68例食管闭锁合并气管-支气管瘘的病例中,有5例婴儿出现复发性食管-呼吸道瘘。