Esophagious

Esophagious's disease overview

esophagus atrophy is one of the most common gastrointestinal birth defects, with a frequency of about 1/4000 children living. The esophagus atrophy is defined as an interruption of esophageal circulation with or without abnormal trade between the esophagus and the trachea.

About 50% congenital esophageal atrophy is combined with other birth defects, which accounts for the highest proportion of VacteraL (the disease consists of many birth defects at the same time as at the same time as at the same time as at the same time like Spine deformities, anal aid, heart defects, tracheic deformities, esophageal malformations, kidney abnormalities and limb abnormalities).

Esophageal atrophy can be diagnosed early before birth by 24 -week -old ultrasound method. Children with esophageal atrophy often have surgery to help children have a higher opportunity to live, if left long, it can easily lead to the risk of pneumonia, pulmonary hypertension, which makes the disease worse. Early detection plays a very important role in treating, if it is detected late, bowel necrosis can cause danger to children.

Currently, although there are advances in the esophagus surgery and recovery, esophagus atrophy is still a disease with a high mortality rate due to the common trachea - esophagus causing pneumonia inhaled pneumonia .

The possible complications of esophageal atrophy are ::

Gastroesophageal reflux disease: Due to after surgery, the center angle is changed

Song swallowing disorders: Because too long children do not breastfeed with oral pathogens with active disorders of esophagus

Soft trachea cartilage: due to extraordinary esophageal abnormalities. Prolonged gastroesophageal reflux causes trachea damage

Causes of Esophagious's disease

Esophageal atrophy is the result of the abnormal embryo process between the 4th and 6th week of pregnancy, which explains the phenomenon of esophageal atrophy often accompanied by many other congenital malformations in Spine, kidneys, genitalia, cardiovascular, digestive.

However, the cause of abnormalities in the process of embryo creation has not been known.

10 ENT pathology related to gastroesophageal reflux

Symptoms of Esophagious's disease

Children with esophageal atrophy often have symptoms:

Poor feeding, reflux when breastfeeding

cough, cyanosis when sucking or eating

Sign "crab foaming"

Stomach catheter does not get down to the stomach (not exceeding 9 - 10cm)

cyanosis, shortness of breath after birth

Excess saliva in the mouth often improves cyanosis but this sign quickly appears

Pneumonia recurrence many times

People at risk for Esophagious's disease

Risk factors that make children get esophageal atrophy are:

Family factors: Children with siblings with esophageal atrophy are at risk of 2%, children with twin siblings with esophageal atrophy are at high risk of disease 6 times more than normal children.

Children with chromosomal abnormalities such as triangle chromosomes No. 21 (Down syndrome), triangle chromosomes No. 13 (Patau syndrome) or triangle Chromosome number 18 (Edwards syndrome)

Older parents: The older the father is at higher risk

Mothers use reproductive support techniques (such as in vitro fertilization, sperm pump, etc.) that risk giving birth higher than non -used people.

Prevention of Esophagious's disease

There is no completely effective way to prevent esophageal atrophy during pregnancy. The best thing that the mother can do during pregnancy is:

There is a scientific diet

Exercise regularly

Rest, avoid stress

Full prenatal check -ups and pre -production tests to detect fetal defects early if any.

Diagnostic measures for Esophagious's disease

Pre -diagnosis: Ultrasound of pregnancy shows the same esophagus on large stretches, amniotic fluid, small stomach.Clinical

In the first breastfeeding, cough, choking or cyanosis

Signs of respiratory failure: fast breathing, cyanosis

Put the stomach catheter into the stomach

lungs: ran moist, ran exploded when pneumonia complications

Find a combination defect, pay special attention to congenital heart

Testing:

X-ray helps:

Survey of indirect image of esophageal atrophy: Rolled or stopped in the chest cannot go down to the stomach

Survey of lung parenchymal lesions (if any): Inhalation pneumonia

Survey of steam in the small intestine when there is tracheta accompanied by

Take the same bag by pumping contrast pills to see images and pocket positions on the esophagus

X-ray of contrast esophagus: Due to the high risk of choking, it is necessary to consult with a X-ray doctor before appointment, which should be used in water. Telebrix) with a small amount of only about 1 ml.

Abdominal ultrasound: Detecting other coordinated defects in the abdomen (urinary, ...).

Determination of heart defects.

Ultrasound: Detecting brain defects.

Blood tests: blood formula, blood -free blood -TS - TC.

All blood clotting when there is a coagulation disorder.

Aortic blood when there is respiratory failure.

Gross's esophageal atrophy classification table: Helps decide on treatment and prognosis

Group A: Esophageal atrophy without holes (8%)

Group B: esophageal atrophy with holes at the head near the esophagus - trachea (<1%)

Group C: Esophageal atrophy with holes at the end of the esophagus - trachea (87%)

Group D: esophageal atrophy with holes at both ends of the esophagus - trachea (<1%)

Group E: esophagus - trachea does not shrink (4%) (4%)

Group F: Esophagic stenosis (<1%)

Esophagious's disease treatments

Principle of treatment of esophageal atrophy :

Institute early to the hospital with pediatric surgery.

Respiratory resuscitation.

high head.

Suction bags and interrupted esophagus to prevent inhaled pneumonia.

Keep warm to avoid lower body heat.

Treatment of inhaled pneumonia if any.

Early esophageal surgery.

Nutrition intravenously.

Care before surgery:

keep warm to avoid lower body temperature

Completely fasting, interrupting bags with the above esophagus and mouth

High head posture (30-45 degrees) or lying on your stomach, changing posture every 30-60 minutes to avoid lung collapse

Feeding by intravenous sugar, maintaining translation according to demand

Antibiotics if there is symptoms of inhaled pneumonia or infection

Monitor signs of cyanosis, shortness of breath due to lack of oxygen

Monitoring and sucking regularly to avoid choking

Perform pre-surgical tests (blood formula, blood clotting function, kidney liver function, blood registration, echocardiography, X-ray)

Regulating electrolyte water disorders, alkaline acidosis.

Detect and treat hypoglycemia.

esophageal atrophy:

Purpose of surgery:

Cut, stitches the trachea - esophagus (if any).

Set up the circulation of the gastrointestinal tract.

Approach: Surgery can be performed by open surgery or laparoscopic surgery.

Surgical type: Depending on the condition of the child, choose the right type of surgery

Surgery 1 includes a fistula cut, the esophagus - end (group C near)

Surgery 2, then open the stomach to the skin then connect the esophagus, the two (usually when the child is 10 kg). Surgery 2 often gives group C's esophageal atrophy with 2 heads apart or the group does not have a hole (group A) because the two heads are not connected.

The standard of surgery:

Severe diverse defects threaten life, especially heart defects or accompanying pulmonary hypertension (> 70mmHg), there is a catheter that must be through the artery. /p>

severe pneumonia.

Severe respiratory failure must help breathe.

weight <2000g.

Currently, the survival rate in the esophagus patient has surgery in Group A is very high> 80%, while Group C is mostly dead. Cases of surgery connecting the esophagus one, the survival rate is high if they are intervened early without pneumonia. Meanwhile, surgery 2 has a very high mortality rate> 90%.

after surgery:

high head, respiratory support

Continuous viscosity suction

fasting, eating with intravenous sugar

X-rays check on the second and Tuesday after surgery, if the child is stable to eat again with the oral line

In case of tension, oral esophageal tension before feeding

Care when discharged from the hospital:

Instructions for mothers to breastfeed properly

closely monitor the condition of children after breastfeeding (signs of shortness of breath, cyanosis, etc.)

Let children go to the doctor immediately if there are abnormal signs

Properly re-examination: Each month for the first 6 months, then every 3-6 months, then every year

See more:

dangerous from gastroesophageal reflux

Esophageal stenosis: Causes, symptoms, diagnosis and treatment

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