Esophageal atresia & TOF

[size=20px]A 12-month old boy who underwent repair of tracheoesophageal fistula and esophageal atresia as a newborn now presents with difficulty transitioning from milk to table food. He underwent balloon dilation at 8 and 10 months of age. An esophagram shows an anastomotic stricture with about 30% patency of the lumen and hangup of contrast flow at the anastomosis. He is currently on weight-appropriate doses of proton pump inhibitor. pH impedance studies show no significant gastroesophageal reflux. The esophageal anastomotic stricture should next be managed with, A higher doses of proton pump inhibitor B bougienage with Savary dilator C dilation with or without…

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[size=20px]A 2 year old child presents to your clinic with persistent dysphagia following esophageal atresia repair at birth. She had no complications following primary repair. She has been managed with daily PPI therapy but has had persistent dysphagia. Radiographic evaluation of the esophagus shows no evidence of stricture. She undergoes endoscopy which shows evidence of esophagitis along the distal esophagus. Biopsies reveal greater than 15 eosinophils per high power field at each of the biopsy sites. What is the best management strategy for this child? A Increase to twice daily PPI therapy B Refer for esophageal motility study C Laparoscopic Fundoplication …

[size=20px]A 10 year old boy with a history of esophageal atresia with a distal tracheoesophageal fistula presents for routine follow up. He has no symptoms of dysphagia or heartburn and is in the normal percentile for growth. Which of the following should be recommended at this point? A observation B esophagram C CT scan D MRI E Endoscopy[/size]

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[size=20px]A two-month old boy was born full term at three kg. He has had two pneumonias and often sputters and becomes cyanotic when fed orally. He has had at least one blue spell resulting in an emergency call by his parents. An upper gastrointestinal series and an oral pharyngeal motility study (OPMS) are normal but contrast appears in the airway. The next step in the evaluation of this patient with recurrent aspiration should be A pH probe. B repeat OPMS. C cardiac echocadiography. D bronchoscopy. E esophagoscopy.[/size]

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[center]Neonatal Open (Thoracotomy)Repair of Esophageal Atresia & Tracheo-esophageal Fistula.Dr Tamer Ashraf see in second post[/center]

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Any one want a high quality PDF of this chart, post in this thread, use a personalized picture as an avatar, and add one thread to the forums, I will send it to you in a private message Edit: available without restrictions

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see video link in second post This video clip demonstrate endoscopic management of recurrent tracheo-esophageal fistula post TOF repair by cauterization of fistula with injection of adhesive glue.

[size=20px]A 4-month old girl underwent repair of esophageal atresia with a distal tracheoesophageal fistula at birth.She continues to have stridor, wheezing, and brief resolved unexplained events (BRUE).Her reflux is controlled with proton pump inhibitors.Airway evaluation demonstrates tracheomalacia and she undergoes aortopexy. Which preoperative factor is associated with increased risk of failure of aortopexy? A Compression from innominate artery B Laxity of cartilaginous rings C > 80% narrowing of trachea D Presence of bronchomalacia E Posterior tracheopexy at initial repair[/size]

[size=20px]A 4-month old girl had repair of esophageal atresia and distal tracheoesophageal fistula at birth.She continues to have stridor, wheezing, and brief resolved unexplained events (BRUE).Her reflux is controlled with proton pump inhibitors.Airway evaluation demonstrates tracheomalacia and she undergoes aortopexy. Which preoperative factor is associated with increased risk of failure of aortopexy? A Compression from innominate artery B Laxity of cartilaginous rings C > 80% narrowing of trachea D Presence of bronchomalacia E Posterior tracheopexy at initial repair[/size]

First one with correct answer with justification win. A 10-year old boy who had esophageal atresia repaired as an infant presents with a food bolus impaction at the prior esophageal anastomosis. He has been taking a proton pump inhibitor. At the time of your flexible endoscopy to clear the esophagus you notice a stricture which you dilate. Distal to the stricture you find abnormal, inflamed appearing distal esophageal mucosa. Biopsies of the area identify metaplasia of the intestinal type. [size=20px]The next best step in management of his patient with esophageal metaplasia is A adding an H2 blocker. B yearly surveillance endoscopy with biopsy. C radiof…

what is the first correct answer and the second correct answer ? [size=20px]An infant undergoes primary repair of esophageal atresia with distal tracheoesophageal fistula. As an adult, his most likely long term problem related to the esophageal atresia repair is: A dysphagia B symptomatic gastroesophageal reflux C asthma D malnutrition E stricture[/size]