1 / 14

OESOPHAGEAL ATRESIA

OESOPHAGEAL ATRESIA. Anne Aspin 2010. Types of oesophageal atresia and fistula. 86%. 7%. 4%. Types continued. 1%. <1. <1. History. First case recorded Durston (1670) Gibson (1697) first recorded with fistula Ladd (1939) first staged repair

gore
Download Presentation

OESOPHAGEAL ATRESIA

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. OESOPHAGEAL ATRESIA Anne Aspin 2010

  2. Types of oesophageal atresia and fistula 86% 7% 4%

  3. Types continued 1% <1 <1

  4. History • First case recorded Durston (1670) • Gibson (1697) first recorded with fistula • Ladd (1939) first staged repair • Height (1941) first successful primary repair.

  5. Survival rate of around 90% • Incidence 1: 4500 • Antenatal diagnosis – polyhydramnios and absent stomach 56% predictive of OA.

  6. After birth • Large NG tube • CXR, AXR • Replogle tube, 10 min suction to pharynx

  7. Associated anomalies • 50% associated anomalies • Cardiac 29% • Vertebral, Anorectal, Cardiac, Tracheo, Oesophageal, Renal, Limb

  8. CHARGE, Coloboma, Heart defects, Atresia choanal, retarded growth and development, Genital Hypoplasia, Ear

  9. Table 1 • Cardiovascular 29% • Gastro intestinal (anorectal 14%) 27% • Genito urinary 13% • Vertebral and skeletal 10% • Respiratory 6% • Genetic 4%

  10. Table 2 • Risk classification for OA • Group BW Major cardiac survival defect 1 >1500 No 96% 2 <1500 or Yes 60% 3 <1500 and Yes 18%

  11. Primary repair • Paralyse and ventilate 5 days post op • Long gap – gastrostomy and assessment of gap, may leave 6 – 12 weeks before primary closure. • Gap of more than 6-8 vertebrae, oesophageal replacement

  12. Post operation- early complications • Anastomotic leak , 27%, 24 – 72hrs • Anastomotic stricture • Recurrent tracheo oesophageal fistula

  13. Late complications • Tracheomalacia • Gastro oesophageal reflux • Respiratory problems • Motility disorders • Growth

  14. Research • Family study – broad spectrum • Relatives of TOF have these anomalies (genetic factor) • Range of medical problems ie dysmotility, reflux –family have these. (Genetic story to investigate) • Vitamin A, Adriamycin (cancer drug)

More Related