Surgical diseases of the chest

Surgical diseases of the chest . Atrial esophagus is a severe developmental disorder that forms in the early stages of embryogenesis, when the esophagus forms a hollow tube and is separated from the respiratory system.

Different forms of atresia are possible. More common is atresia with the formation of a blind upper segment of the esophagus and a lower segment that communicates with the trachea with a fistulous course. Clinical symptoms of atresia of the esophagus appear immediately after birth: attacks of cyanosis, apnea due to the accumulation of mucus in the pharynx, foamy discharge from the mouth. When trying to feed, the phenomena of respiratory failure caused by the aspiration of milk are increasing. The child becomes restless, cyanosis increases, dyspnea, a bubbling breath appears, a lot of wet wheezing is audible in the lungs. As a rule, pneumonia occurs due to the aspiration of milk, saliva and the throwing of gastric contents into the trachea through the tracheoesophageal fistula.

In the presence of these symptoms, esophageal sounding is indicated. If there is atresia, the catheter rests against the blind end of the esophagus; When air is introduced, it goes out with a noise through the mouth and nose of the child. To establish the level of atresia, an X-ray examination with a catheter without contrast agent is performed. The presence on the roentgenogram of a gas bubble in the stomach indicates the communication of the lower segment of the esophagus with the trachea. Rarely found nesvischevaya form of esophagus atresia, in which gas in the stomach is not determined.

Treatment of esophageal atresia is surgical. Preparations for the operation should be started in the maternity hospital: sucking mucus from the mouth, giving moistened oxygen, excluding feeding through the mouth and conducting post-prandial therapy. The method of surgical intervention depends on the form of atresia and the magnitude of diastase between the blind ends of the esophagus. The best results were obtained by performing direct esophageal anastomosis end to end with the timely arrival of the child in the hospital.