Newborn baby with regurgitation of feeds and continuous drooling of saliva is:
Ans. a. Esophageal atresiaESOPHAGEAL ATRESIA (EA) AND TRACHEOESOPHAGEAL FISTULA (TEF)Three basic types:Isolated EAIsolated (H-type) TEFEA and distal TEFMost common anatomy is upper esophagus ends in blind pouch and TEF connected to distal esophagusH-type--presents chronically and diagnosed later in life with chronic respiratory problemsHalf with associated anomalies--VACTERL associationVACTERL AssociationNonrandom association of birth defects:Vertebra! anomaliesAna! atresiaCardiac defectTracheoEsophageal fistulaRenal anamoliesLimb abnormalitiesClinical presentation in neonate (EA or EA+TEF)Bubbling, Frothing, cyanosis, cough, and respiratory distressWith feedings - immediate regurgitation and aspirationClinical presentation with just TEF--feeding problems and recurrent aspirationDiagnosisInability to pass nasogastric/orogastric tubeIsolated TEF: Esophagram with contrast media (or bronchoscopy or endoscopy with methylene blue)Esophageal atresia: X-ray shows coiled nasogastric tube in blind pouch with no distal gas (gasless abdomen)Esophageal atresia and distal fistula: Coiled nasogastric tube in blind pouch the large amount of air in stomach and intestinesTreatment--surgical ligation of TEF and resection with end-to-end anastomosis of esophageal atresia
Esophageal atresia
GERD
Diffuse esophageal spasm (DES)
Zenker's diverticulum
Oesophagus