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):
1

MC congenital anomaly of the esophagus

Esophageal atresia (EA)

2

T/F Majority of EA have an associated TEF

T

3

MC form of EA

Type A: Proximal EA with distal TEF

4

Types of EA in order of frequency

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

Associated features of EA

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

6

Highest risks for mortality in neonates with TEF

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

7

___% of patients with EA are nonsyndromic

50%

8

MC anomaly associated with EA

VATER or VACTERL syndrome

9

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

T

10

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

Type C or H-type fistula

11

Perinatal radiographic findings that might alert the physician to EA

Absence of the infant stomach bubble and maternal polyhydramnios

12

EA that can manifest as an air-distended stomach

Distal TEF

13

EA that can manifest as an airless scaphoid abdomen

Pure EA

14

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

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

Positioning that minimizes movement of gastric secretions into a distal fistula

Prone

16

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

T, it can worsen distention of abdominal viscera

17

Current standard surgical approach to an EA with TEF

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

18

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

Fistula ligation and gastrostomy tube placement

19

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

>3-4cm

20

Options for repair of widely gapped EA

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

21

___ 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

GERD

22

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

Tracheomalacia