Beasley S W, Myers N A
Department of General Paediatric Surgery, Royal Children's Hospital, Parkville, Victoria, Australia.
J Pediatr Surg. 1988 May;23(5):415-7. doi: 10.1016/s0022-3468(88)80437-8.
Congenital tracheoesophageal fistula presents with clinical features of variable types and severity, including choking, coughing, and cyanosis with feeds, pneumonia, and abdominal distension. The rarity of the condition, its nonspecific symptomatology, and limitations in its demonstration by contrast radiology and endoscopy contribute to delays between first presentation and confirmation of the diagnosis. Recognition of symptom complexes and a high index of clinical suspicion should assist early diagnosis. In our experience with 30 infants with "H" fistula, an initial barium swallow demonstrated the fistula in 73%, and in all patients by the third attempt. Refinements in technique have shown contrast radiology to be satisfactory and safe in the initial investigation of infants with suspected congenital tracheoesophageal fistula and enables differentiation from other causes of aspiration.
先天性气管食管瘘具有多种类型和严重程度的临床特征，包括喂奶时呛咳、咳嗽、发绀、肺炎和腹胀。该病较为罕见，症状缺乏特异性，且造影放射学和内镜检查在显示病变方面存在局限性，这些因素导致从首次出现症状到确诊之间存在延迟。认识症状组合并保持高度的临床怀疑有助于早期诊断。根据我们对30例“H”型瘘管婴儿的经验，初次钡餐吞咽检查显示瘘管的比例为73%，第三次检查时所有患者均显示出瘘管。技术的改进表明，造影放射学在疑似先天性气管食管瘘婴儿的初步检查中是令人满意且安全的，并且能够与其他误吸原因相鉴别。
