GrossB型食道鎖閉症の診断と治療

概要

論文の詳細を見る
Esophageal atresia with the proximal tracheoesophageal fistula is very rare. Two cases have been experienced at our hospitals. In the first case who died of pneumonia on the 9th day after admission, a proximal tracheoesophageal fistula was discovered at autopsy. In the second case, there were no specific symptom and sign suggesting the proximal tracheoesopageal fistula. Only mild degree atelectasis in the right upper lobe had been seen until severe pneumonia occured at the third month. The proximal tracheoesphageal fistula was demonstrated by esophagography. A transcervical ligation of the fistula was performed immediately after diagnosis. In contrast, 6 cases of esopageal atresia without fistula (Gross's A type) in our experience had never suffered from pneumonia or atelectasis before the radical operation. So, when pneumonia occures in a case with esophageal atresia without fistula, the proximal tracheoesophageal fistula shoud be examined by either esophagography or bronchoscopy. Ligation of the fistula seems less dangerous by transcervical approach than transthoracic approach. An adequate exposure of the fistula located above T-2 vertebra is possible by transcervical approach but an attention must be payed not to injure the recurrent laryngeal nerve.
日本小児外科学会の論文
1982-02-20