Ch. 319 - Congenital Anomalies (Esophagus Only) Flashcards Preview

Nelson - The Digestive System > Ch. 319 - Congenital Anomalies (Esophagus Only) > Flashcards

Flashcards in Ch. 319 - Congenital Anomalies (Esophagus Only) Deck (22)
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1
Q

MC congenital anomaly of the esophagus

A

Esophageal atresia (EA)

2
Q

T/F Majority of EA have an associated TEF

A

T

3
Q

MC form of EA

A

Type A: Proximal EA with distal TEF

4
Q

Types of EA in order of frequency

A

A: Proximal pouch with distal TEF, B: Proximal and distal pouch with no TEF, C: TEF (H-type) D: Proximal TEF with distal pouch, E: Proximal and distal TEF

5
Q

Associated features of EA

A

1) Advanced maternal age 2) European ethnicity 3) Obesity 4) Low socioeconomic status 5) Tobacco smoking

6
Q

Highest risks for mortality in neonates with TEF

A

1) Less than 1500g at birth 2) Severe cardiac anomalies

7
Q

___% of patients with EA are nonsyndromic

A

50%

8
Q

MC anomaly associated with EA

A

VATER or VACTERL syndrome

9
Q

T/F Aspiration of gastric contents via a distal fistula causes more damaging pneumonitis than aspiration of pharyngeal secretions from the blind upper pouch

A

T

10
Q

Type of TEF that might come into medical attention later in life with chronic respiratory problems, including refractory bronchospasm and recurrent pneumonia

A

Type C or H-type fistula

11
Q

Perinatal radiographic findings that might alert the physician to EA

A

Absence of the infant stomach bubble and maternal polyhydramnios

12
Q

EA that can manifest as an air-distended stomach

A

Distal TEF

13
Q

EA that can manifest as an airless scaphoid abdomen

A

Pure EA

14
Q

Imaging modalities that can demonstrate an isolated TEF (H-type)

A

1) Esophagogram with contrast medium injected under pressure 2) Bronchoscopy 3) Methylene blue dye injected into the ET tube during endoscopy is observed in the esophagus during forced inspiration

15
Q

Positioning that minimizes movement of gastric secretions into a distal fistula

A

Prone

16
Q

T/F ET intubation with mech ventilation is to be avoided in patients with EA

A

T, it can worsen distention of abdominal viscera

17
Q

Current standard surgical approach to an EA with TEF

A

Surgical ligation of TEF and primary end-to-end anastomosis of the esophagus via a right-sided thoracotomy

18
Q

Temporizing surgical intervention for EA in patients who are premature or otherwise complicated

A

Fistula ligation and gastrostomy tube placement

19
Q

Primary repair cannot be done if the gap between the atretic ends of the esophagus is

A

> 3-4cm

20
Q

Options for repair of widely gapped EA

A

Using gastric, jejunal, or colonic segments interposed as a neoesophagus

21
Q

___ contributes significantly to the respiratory disease (reactive airway disease) that often accompanies EA and TEF and also worsens the frequent anastomotic strictures after repair of EA

A

GERD

22
Q

Pulmonary condition associated with EA with TEF that improves as the child grows

A

Tracheomalacia