18 Questions
What is the characteristic symptom of babies with Esophageal atresia?
Polyhydramnios in mothers
What is the main nutrition problem in babies with Esophageal atresia?
Food does not reach the stomach
What is the correct anatomy of the esophagus in Esophageal atresia?
The upper segment of the esophagus ends in a blind pouch
What is the most dangerous problem associated with Esophageal atresia?
Aspiration
What is the association of Esophageal atresia with other congenital defects?
VACTERL
What is the type of Tracheoesophageal fistula characterized by the upper segment of the esophagus ending in a blind pouch and the lower segment connected by a fistula to the trachea?
Type C
What is the primary reason why a baby with esophageal atresia does not swallow in the womb?
Because the baby's esophagus is not connected to the stomach
What is a significant symptom of esophageal atresia/tracheoesophageal fistula during feeding?
Coughing during feeding
What is the term for the connection between the esophagus and trachea?
Fistula
Why is it important to monitor the baby's first feeding with the mother?
To see how the baby responds to feeding and to prevent aspiration
What is the consequence of not halting breastfeeding when the baby is coughing during feeding?
The baby will turn blue due to milk entering the lungs
What is the characteristic of the abdomen in a baby with esophageal atresia/tracheoesophageal fistula?
Very round
What is the purpose of inserting an NGT in a child with Esophageal Atresia/Tracheoesophageal Fistula?
To drain secretions and decompress the stomach
What is the primary diagnostic tool used to confirm the type of Esophageal Atresia/Tracheoesophageal Fistula?
Barium swallow
Why is parenteral fluid/TPN necessary in the management of Esophageal Atresia/Tracheoesophageal Fistula?
To provide nutritional support
What is a potential complication of continuous TPN administration?
Overwhelming the liver's ability to absorb its components
What is the primary goal of surgical intervention in Esophageal Atresia/Tracheoesophageal Fistula?
To resolve the congenital defect
Why is it necessary to monitor blood glucose levels in patients with Esophageal Atresia/Tracheoesophageal Fistula?
To monitor for hyperglycemia
Study Notes
Esophageal Atresia and Tracheoesophageal Fistula
- Esophageal atresia is a failure to connect the upper segment of the esophagus with the lower segment, resulting in a blind pouch.
- In tracheoesophageal fistula, the upper segment of the esophagus ends in a blind pouch, and the lower segment is connected by a fistula to the trachea.
Types of Esophageal Atresia and Tracheoesophageal Fistula
- Most common type: upper segment of the esophagus ends in a blind pouch, and the lower segment is connected by a fistula to the trachea.
- Other types: both upper and lower segments are connected by a fistula to the trachea, and a fistula is present between an otherwise normal esophagus and trachea (classic H-type).
Symptoms
- Drooling of mucus after birth (blowing bubbles)
- Mother with polyhydramnios (in the womb, babies with atresia do not swallow)
- 3 C's during feeding: choking, coughing, and cyanosis
- Very round full abdomen due to swallowing air
Diagnostics
- X-ray shows coiling of firm catheter (NGT insertion)
- Ultrasound shows stomach distended with air
- Barium swallow to confirm the type of EA/TEF
- Bronchial endoscopy shows blind-end esophagus and fistula
Management
- Surgery is the only treatment for EA/TEF
- Parenteral fluid/TPN administration as necessary
- NGT to drain secretions and decompress the stomach
- Suction if necessary to prevent aspiration
- IV meds to decrease stomach acid secretion
- Need for antibiotic infusion if necessary
This quiz covers the anatomy and symptoms of esophageal atresia and tracheoesophageal fistula, including the presentation of symptoms in utero and the effects on the mother. It also explores the different types of connections between the esophagus and trachea.
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