Professional Documents
Culture Documents
Gastric
bubble
Spine Umbilical
cord
Cross sectional view of fetal abdomen with vertebral column to left of the
image, the gastric bubble above and the umbilical cord to the right.
Absence of
gastric
bubble
Umbilical
Spine cord
Umbilical
vein
small gastric
bubble
collapsed
Spine
5 TYPES OF MALFORMATION
4% Isolated tracheo-oesophageal a
H Type fistula with no atresia
SPINE
HEAD FEET
Before 1939 when the first successful repair took place this
diagnosis was fatal
Associated congenital
abnormalities are discovered in
approximately one half of
patients with oesophageal
atresia
Replogle tube
Fewer musculoskeletal
sequelae
Winging of the scapula
Asymmetrical chest wall
Thoracic scoliosis
Breast maldevelopment
Pathogenesis
Use silk sutures at the anastomosis
Excessive anastomotic tension
Excessive distal oesophageal
mobilisation
Colonic interposition graft necrosis
Pathogenesis
Anastomotic leak
Two layer anastomosis
Anastomosis under tension
Silk sutures
Gap length at presentation
Associated gastro-oesophageal reflux
Oesophageal function
Disordered oesophageal motility
Barium swallow
Oesophageal function tests
Manometry
pH studies
No progressive peristalsis
Lack of co-ordinated peristaltic
stripping wave
Oesophageal contractions
simultaneous
Incompetent gastro-
oesophageal sphincter
? Iatrogenic hiatus hernia
Oesophagitis
Symptoms persist into adult life
Respiratory
Recurrent bronchitis
Persistent cough - TOF cough
Pneumonia
Tracheomalacia (reported in up to
10%)
Association between
oesophageal stricture and
recurrent bronchitis
Symptoms relating to
dysmotility and reflux have a
significant impact
Frequently persist into adulthood