Tracheoesophageal fistula

Mitochondrial disorders are not commonly regarded as causes of malformations. Facial features included round face, high forehead, small nose, and long flat philtrum, reminiscent of the fetal alcohol syndrome. Limb and trunk involvements included short hands, brachydactyly, hypoplasia of the distal and middle phalanges, hypoplastic nails, and the VACTERL [vertebral anomalies, anal atresia, cardiovascular anomalies, tracheoesophageal fistula, esophageal atresia, renal (kidney) and/or radial anomalies, and preaxial limb anomalies (in front of or above the central axis of the limb)] association [50]. 

In 36 patients with inoperable cancers of the esophagus who were treated by endoscopic injection of alcohol, complications included mediastinitis in one patient and tracheoesophageal fistulas in two (7). 

A neonate who needed a tracheostomy 10 days after a tracheoesophageal fistula repair was given intravenous lidocaine, 1 mg/kg followed 15-20 minutes later by 0.7 mg/kg. Immediately after, tonic-clonic seizures developed. The child recovered, with no observable ill effects at 6 months. 

Baby Boy Doe was born with Down s syndrome (trisomy 21) and with a tracheoesophageal fistula. The infant s parents were informed that surgery to correct his fistula would have "an even chance of success." Left untreated, the fistula would soon lead to the infant s death from starvation or pneumonia. The parents, who also had two healthy children, chose to withhold food and treatment and let nature take its course. ... 

Connolly B, Alton DJ, Ein SH et al (1995) Partially reduced intussusception when are repeated delayed reduction attempts appropriate Pediatr Radiol 25 104-107 Cotran RS, Kumar V, Robbins SL (1989) Appendix. In Saunders WB (ed) Robbins pathologic basis of disease, 4th edn. Saunders, Philadelphia, pp 902-904 Crowe JE, Sumner TE (1978) Combined esophageal and duodenal atresia without tracheoesophageal fistula characteristic radiographic changes. AJR Am J Roentgenol 130 167-168... 

Fig. 2.5. Esophageal atresia with distal tracheoesophageal fistula. The orogastric tube tip is in the hlind-ending esophagus and gas is present in loops ofhowelin the abdomen. Note the right cervical rib and left 13 rib...

Fig. 2.6. Esophageal atresia without distal tracheoesophageal fistula. The abdomen is gasless. Duodenal atresia was diagnosed at the time of surgical repair...

Fig. 2.10. Lateral pouchogram with esophageal atresia and proximal tracheoesophageal fistula. Contrast medium fills the blind-ending esophageal pouch and a narrow fistula connects to the trachea...

Fig. 2.11. Tracheoesophageal fistula. The fistulous connection to the trachea was opacified during the barium swallowexamination. The fistula has an oblique cephalad course...

Berdon WE, Baker DH, Schulinger )N, Santulli TV (1979) Plain film detection of right aortic arch in infants with esophageal atresia and tracheoesophageal fistula. I Pediatr Surg 14 436-437... 

Cumming WA (1975) Esophageal atresia and tracheoesophageal fistula. Radiol Clin North Am 13 277-295... 

Engum SA, Grosfeld JL, West KW et al (1995) Analysis of morbidity and mortality in 227 cases of esophageal atresia and/or tracheoesophageal fistula over two decades. Arch Surg 130 502-508... 

Although a safe procedure, contraindications for balloon dilation do exist, and these are considered to be multiple (> 3) strictures, long strictures (> 5 cm), tortuous strictures, or patients with tracheoesophageal fistulas (Hamza et al. 2003). 

Pense SC, et al. (1988) Tracheoesophageal fistula secondary to muriatic acid ingestion. Burns 14 35-38... 

Martini N, Goodner JT,D Angio GJ,et al. (1970) Tracheoesophageal fistula due to cancer. J Cardiovasc Surg 59 319-324 MacDonald S, Edwards RD, Moss JG (2000) Patient tolerance of cervical esophageal metallic stents. JVIR 11 891-898... 

Finally, the two groups from Heidelberg, Germany and Boston, MA reported successful placement of covered Ultraflex stents for sealing tracheoesophageal fistulas in ten patients. However, the authors do not report whether the fistulas were successfully sealed off (Herth et al. 2001). 

Levine and Muenke (1991) reported the case of a pregnant lead worker who sustained brief, early, and quite elevated workplace exposure and delivered an infant with virtually aU of the characteristic defects defining the VACTERL association seen with other human cases, where Pb was not explicitly identified as present. VACTERL refers to collective vertebral anomalies, anal artresia, cardiac defect, renal anomalies, and limb anomalies only tracheoesophageal fistula was absent. A striking feature of these birth defects was their similarity to high-dose birth defects found in various test animal species, a urorecto/caudal pattern of malformations. 

Very frequently more than one organ system is involved. This is also reflected by the so-called VATER or VACTERL association that combines vertebral anomalies, anorectal atresia, cardiac failure, tracheoesophageal fistula, esophageal atresia, renal dysplasia, and limb malformation. 

Congenital anomalies (e.g., cleft palate, tracheoesophageal fistula)... 

---