Congenital tracheoesophageal fistula without esophageal atresia.
The authors report a series of eight cases of isolated tracheoesophageal fistula without esophageal atresia (or an H type fistula), treated in three pediatric ENT departments. This is a rare malformation whose diagnosis requires investigation for associated anomalies. The clinical signs are mainly respiratory but also digestive and the symptomatology can be severe. The diagnosis can be made with a barium swallow combined with cineradiography, but a tracheoesophageal endoscopy remains the investigation of choice. The treatment is surgical. In most cases, the fistula is accessible by a right or left cervicotomy, depending on the surgeon's practice, with a much lower postoperative morbidity as compared to a thoracotomy. The postoperative management was straightforward in most of our cases. We discuss the role of gastro-esophageal reflux with respect to postoperative morbidity as well as systematic treatment for reflux peri-operatively. The pros and cons of the various surgical approaches are also discussed.
Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-faciale, CHU Bicêtre, Le Kremlin-Bicêtre, France.
E
E
Genty
P
P
Attal
R
R
Nicollas
G
G
Roger
J M
JM
Triglia
E N
EN
Garabedian
S
S
Bobin
D001465:Barium Radioisotopes; D003937:Diagnosis, Differential; D004933:Esophageal Atresia / Q000175:diagnosis*; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000517:prevention & control; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014138:Tracheoesophageal Fistula / Q000151:congenital* / Q000175:diagnosis* / Q000601:surgery
D001465:Barium Radioisotopes