Tracheoesophageal fistula repair - series?

Tracheoesophageal fistula repair - series?
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Normal anatomyThe trachea and esophagus run next to each other through the chest cavity. The esophagus connects to the stomach, and carries food and saliva to the stomach. The trachea connects to the lungs and carries air to the lungs.IndicationsA tracheoesophageal fistula is a congenital anomaly in which there is a connection between the trachea and the esophagus. This is a life-threatening problem requiring immediate intervention. Saliva and gastric secretions may be aspirated into the lungs through the abnormal opening in the trachea. Normal swallowing and digestion of food cannot occur with the abnormal esophagus.Procedure, part 1Although the surgical procedure varies depending on the location and type of fistula, in general, an incision is made in the right chest. The section of esophagus that contains the fistula is resected.Procedure, part 2The ends of the esophagus are sutured back together. In many cases, infants are very ill, and therefore require a staged procedure. This involves placing a tube in the stomach (gastrostomy tube), in order to decompress the stomach and prevent fluid in the stomach from flowing up the esophagus, through the fistula and into the lungs. The infant is then cared for in an intensive care unit until he or she is well enough to undergo resection of the fistula and a definitive repair of the esophagus.AftercareThe baby will be cared for pre-operatively and post-operatively in a neonatal intensive care unit. He/she will be placed in an isolette (incubator) to keep warm. He/she may require oxygen and/or mechanical ventilation. A chest tube may be in place to drain fluids. Intravenous fluids and pain medications will be given. Feedings will be started as soon as possible, depending on the extent of the repair. Length of the hospitalization varies, depending on the seriousness of the surgery and the baby's condition.Reviewed ByReview Date: 08/11/2011David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Related questions

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Description : What is the proper diagnostic machine to see a tear or fistula in the digestive tract or reproductive organs?

Last Answer : answer:A CT Scan can be done with or without contrast and may be able to show a tear or fistula. They can also be done with dye in the blood stream to look for bleeding (like an angiogram) in the ... may not notice a small tear. The best way to look for a tear or fistula would be with endoscopy.

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Is fistula genetic? How can it be treated?

Description : Is fistula genetic? How can it be treated?

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Description : Fistula?

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Description : Pulmonary arteriovenous fistula?

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Coronary artery fistula?

Description : Coronary artery fistula?

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A 47-year-old patient undergoing a complicated laparotomy for bowel obstruction develops a postoperative enterocutaneous fistula. Which of the following statement(s) is/are true concerning parenteral nutritional support in the postoperative period? a. Oral intake can result in severe dehydration, electrolyte abnormalities, and perifistula skin injury b. Total parenteral nutrition increases the spontaneous closure rate of intestinal fistula c. Total parenteral nutrition decreases mortality rate in patients with intestinal fistulas d. The use of TPN better prepares the patient for surgery if surgical intervention proves necessary

Description : A 47-year-old patient undergoing a complicated laparotomy for bowel obstruction develops a postoperative enterocutaneous fistula. Which of the following statement(s) is/are true concerning parenteral ... use of TPN better prepares the patient for surgery if surgical intervention proves necessary

Last Answer : Answer: a, b, d Patients with gastrointestinal-cutaneous fistulas represent the classical indication for TPN. In such patients, oral intake of food almost invariably results in increased ... treated more aggressively surgically after a defined period of nutritional support (unless closure occurs)

Which of the following is true of loss of gastrointestinal secretions? A. Gastric losses are best replaced with a balanced salt solution. B. Potassium supplementation is unnecessary in replacement of gastric secretions. C. Bicarbonate wasting is an unusual complication of a high-volume pancreatic fistula. D. Balanced salt solution is a reasonable replacement fluid for a small bowel fistula. E. A patient with persistent vomiting usually requires hyperchloremic replacement fluids.

Description : Which of the following is true of loss of gastrointestinal secretions? A. Gastric losses are best replaced with a balanced salt solution. B. Potassium supplementation is unnecessary in ... bowel fistula. E. A patient with persistent vomiting usually requires hyperchloremic replacement fluids.

Last Answer : Answer: DE DISCUSSION: Gastric secretions are relatively high in chloride and potassium. Other than an isolated pancreatic fistula, gastrointestinal tract losses below the pylorus ... Although potassium concentrations are low, copious losses require potassium supplementation to prevent hypokalemia

An opening between the bladder and the vagina is called a a) vesicovaginal fistula. A vesicovaginal fistula may occur because of tissue injury sustained during surgery, vaginal delivery, or a disease process.

Description : An opening between the bladder and the vagina is called a a) vesicovaginal fistula. A vesicovaginal fistula may occur because of tissue injury sustained during surgery, vaginal delivery, or a disease ... d) rectovaginal fistula. A rectovaginal fistula is an opening between the rectum and the vagina.

Last Answer : a) vesicovaginal fistula. A vesicovaginal fistula may occur because of tissue injury sustained during surgery, vaginal delivery, or a disease process.

A longitudinal tear or ulceration in the lining of the anal canal is termed a (an) a) anal fissure. Fissures are usually caused by the trauma of passing a large, firm stool or from persistent tightening of the anal canal secondary to stress or anxiety (leading to constipation). b) anorectal abscess. An anorectal abscess is an infection in the pararectal spaces. c) anal fistula. An anal fistula is a tiny, tubular, fibrous tract that extends into the anal canal from an opening located beside the anus. d) hemorrhoid. A hemorrhoid is a dilated portion of vein in the anal canal.

Description : A longitudinal tear or ulceration in the lining of the anal canal is termed a (an) a) anal fissure. Fissures are usually caused by the trauma of passing a large, firm stool or from persistent ... beside the anus. d) hemorrhoid. A hemorrhoid is a dilated portion of vein in the anal canal.

Last Answer : a) anal fissure. Fissures are usually caused by the trauma of passing a large, firm stool or from persistent tightening of the anal canal secondary to stress or anxiety (leading to constipation).

A persistent oroantral fistula for a 12 weeks period following the extraction of a maxillary first permanent molar is best treated by, a. Further review and reassurance since it will most probably heal spontaneously. b.Antibiotic therapy and nasal decongestants. c. Curettage and dressing of the defect. d. Excision of the fistula and surgical closure. e. Maxillary antral wash out and nasal antrostomy.

Description : A persistent oroantral fistula for a 12 weeks period following the extraction of a maxillary first permanent molar is best treated by, a. Further review and reassurance since it will most ... Excision of the fistula and surgical closure. e. Maxillary antral wash out and nasal antrostomy.

Last Answer : d. Excision of the fistula and surgical closure.

What is your management with a chronic oral antral fistula for some time after the extraction of maxillary first molar: A. Surgical closure B. Anti-biotic and nasal decongestant C. Wash the antrum D. All of the above

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Last Answer : D. All of the above

A persistent oroantral fistula for a 12 weeks period following the extraction of a maxillary first permanent molar is best treated by,** A. Further review and reassurance since it will most probably heal spontaneously B. Antibiotic therapy and nasal decongestants C. Curettage and dressing of the defect D. Excision of the fistula and surgical closure E. Maxillary antral wash out and nasal antrostomy.

Description : A persistent oroantral fistula for a 12 weeks period following the extraction of a maxillary first permanent molar is best treated by,** A. Further review and reassurance since it will most ... . Excision of the fistula and surgical closure E. Maxillary antral wash out and nasal antrostomy.

Last Answer : D. Excision of the fistula and surgical closure

The most common cause of vesicovaginal fistula (VVF) in under developed countries would be: a) Obstetrical injuries. b) Pelvic irradiation. c) Carcinoma . d) Haemorrhoidectomy. e) Operative injury.

Description : The most common cause of vesicovaginal fistula (VVF) in under developed countries would be: a) Obstetrical injuries. b) Pelvic irradiation. c) Carcinoma . d) Haemorrhoidectomy. e) Operative injury.

Last Answer : a) Obstetrical injuries.

A 40 years old multiparous woman complains of involuntary loss of urine associated with coughing, laughing, lifting or standing. The history is most suggestive of: a) Fistula. b) Stress incontinence. c) Urge incontinence. d) Urethral diverticulum. e) Urinary tract infection.

Description : A 40 years old multiparous woman complains of involuntary loss of urine associated with coughing, laughing, lifting or standing. The history is most suggestive of: a) Fistula. b) Stress incontinence. c) Urge incontinence. d) Urethral diverticulum. e) Urinary tract infection.

Last Answer : b) Stress incontinence.

The most common cause of rectovaginal fistula is: a) Obstetrical. b) Irradiation of the pelvis. c) Carcinoma. d) Crohn’s disease. e) Endometriosis.

Description : The most common cause of rectovaginal fistula is: a) Obstetrical. b) Irradiation of the pelvis. c) Carcinoma. d) Crohn’s disease. e) Endometriosis.

Last Answer : a) Obstetrical.

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