Ghasaq nadhom amp Widad najeeb Supervised by DrAli Farooq Case 1 2 days male infant presented with difficulty in breathing and feeding since birth with excessive secretion from mouth and nose frothy secretion on examination the baby is ID: 932627
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Pediatric surgery IBY: Ghasaq nadhom & Widad najeeb
Supervised by: Dr.Ali Farooq
Slide2Case 1:2 days male infant presented with difficulty in breathing and feeding since birth with excessive secretion from mouth and nose (frothy secretion) on examination the baby is tachypneic , subcostal recession are present , when the doctor try to put NG tube he failed So what is the diagnosis ?esophageal atresia + tracheoesophageal
fistula
Slide3Pathophysiology:Blind end esophageal pouch = pooled secretion. Fistulous connection with trachea = aspiration. Disordered peristalsis in lower esophagus = GERD. Tracheomalacia
= respiratory obstrucrtion
Slide4Presentation:Polyhydraminous. Frothy secretion. Respiratory distress. Resistance to NG tube insertion. Plain X-ray
Slide5Q2. What is the classification of EA+TEF and what is the most common type ?Type A - Esophageal atresia without fistula or so-called pure esophageal atresia (10%) Type B - Esophageal atresia with proximal TEF (<1%) Type C - Esophageal atresia with distal TEF (85%) Type D - Esophageal atresia with proximal and distal TEFs (<1%)
Type E - TEF without esophageal atresia or so-called H-type fistula (4%)
Slide6Classification:
Slide7Q3. What are the management ?initial management :-1-Suctioning.2- Positioning. (45° sitting position)3-Vascular line.4-
Endotracheal intubation. 5-Incubator , warm , humidity. 6-Check for associated anomalies. 7-Referral to pediatric surgical center
Slide8operative management :- Pre-op. Echo study. Intra-op. Esophagoscopy. Intra-op. Bronchoscopy. ThoracotomyA transverse right thoracotomy incision is made from the anterior axillary line to approximately one fingerbreadth posterior to the posterior axillary line at a level 1 cm inferior to the palpable tip of the scapula
Slide9Thank you