title: Impaired peripheral airway function in adults following repair of esophageal atresia.
abstract: BACKGROUND
  Esophageal atresia (EA) often leads to persistent symptoms and impaired respiratory function in adulthood. The role of peripheral airways in this impairment has not been previously investigated. Furthermore, asthma-like symptoms are common in these patients.
  
  
  OBJECTIVE
  The purpose of this study was to investigate pulmonary outcome, including possible peripheral airway dysfunction, perhaps missed by conventional pulmonary function tests and to see if the diagnosis asthma was accurate.
  
  
  METHODS
  Twenty eight patients operated for EA in Gothenburg 1968-1983 answered a questionnaire regarding respiratory symptoms and underwent pulmonary function tests. Peripheral airway function was measured by multiple breath washout.
  
  
  RESULTS
  22/28 (79%) patients had a history of respiratory symptoms. Abnormal peripheral airway function was found in 17 (61%) patients, while only 6 (21%) patients displayed values indicating central obstruction. Nine patients had restrictive disease. Airway hyperresponsiveness was frequent and associated with atopy and airway inflammation. However, respiratory symptoms or doctor-diagnosed asthma did not correlate with any specific lung function test abnormality.
  
  
  CONCLUSIONS
  Different lung function abnormalities are present in EA survivors, and peripheral airway disease is common. Classical asthma seems to be difficult to diagnose in this patient group. Given the high prevalence of respiratory morbidity, long-term follow-up of pulmonary function, including peripheral airway function, is warranted.
authors.affiliation: Department of Pediatric Surgery, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden. Electronic address: vladimir.gatzinsky@vgregion.se.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Gatzinsky
authors.affiliation: Department of Pediatrics, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Wennergren
authors.affiliation: Department of Pediatric Surgery, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden.
authors.forename: Linus
authors.initials: L
authors.lastname: Jönsson
authors.affiliation: Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Linda
authors.initials: L
authors.lastname: Ekerljung
authors.affiliation: Department of Clinical Physiology, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Houltz
authors.affiliation: Department of Pediatric Clinical Physiology, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Redfors
authors.affiliation: Department of Pediatric Surgery, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden.
authors.forename: Ulla
authors.initials: U
authors.lastname: Sillén
authors.affiliation: Department of Pediatric Clinical Physiology, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden; Department of Pediatrics, Central Hospital, Skövde, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Gustafsson
mesh_terms: D000328:Adult; D001249:Asthma / Q000150:complications / Q000175:diagnosis; D004933:Esophageal Atresia / Q000150:complications* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D012120:Respiration Disorders / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D012129:Respiratory Function Tests
keywords: Asthma; Long-term outcome; Lung clearance index; Multiple breath washout; Pulmonary function