1.Clinical characteristics and serious complications of esophageal button battery ingestion in the pediatric on 83 cases.
Feng Zhen ZHANG ; Qing Chuan DUAN ; Gui Xiang WANG ; Xiao Jian YANG ; Wei ZHANG ; Jing ZHAO ; Hua WANG ; Hong Bin LI ; Xin NI ; Jie ZHANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(5):481-485
Objective: To analyze the clinical characteristics and complications of esophageal foreign bodies of button battery ingestion in children. Methods: A retrospective descriptive study included 83 children who were hospitalized in our hospital on account of button battery ingestion from January 2011 to December 2021. There were 50 males (60.2%) and 33 females (39.8%). The age ranged from 7.6 months to one month off 10 years, with a median age of 18 months. The data of patient demographics and time from ingestion to admission, location, symptoms, management, complications, and follow-up outcome were recorded. SPSS17.0 software was used for statistical analysis. Results: Seventy-two children (86.7%) were younger than 3 years old. The time from ingestion to admission ranged from 1 h to 2 months, with a median time of 8 h. Among the 63 children who were first diagnosed in our hospital, the most common clinical symptoms were nausea and vomiting (32 cases, 50.8%), dysphagia (31 cases, 49.2%), salivation (11 cases, 17.5%) and fever (10 cases, 15.9%). Seventy-three of 83 cases had complete preoperative diagnostic tests, and 55 cases (75.3%) were diagnosed by X-ray. In 56 cases (76.7%), the foreign badies were impacted in the upper third of esophagus. In 72 cases (86.7%), the foreign badies were removed by rigid esophagoscopy. 23 (27.7%) had serious complications, including tracheoesophageal fistula in 15 cases(TEF;65.2%), vocal cord paralysis (VCP;34.8%) in 8 cases, esophageal perforation in 3 cases (EP;13.0%), hemorrhage in 3 cases(13.0%), mediastinitis in 3 cases (13%), and periesophageal abscess in 1 case (4.3%). There were significant differences in the exposure time of foreign bodies and unwitnessed ingestion by guardians in the complications group (P<0.05). 2 cases died (2.4%)respectively due to arterial esophageal fistula bleeding and respiratory failure caused by stent displacement during the treatment of tracheoesophageal fistula. Conclusion: Accidental button battery ingestion can be life-threatening. and it mostly happens in children under 3 years old. Serious complications may happen cause of non-specific clinical manifestations and unwitnessed ingestions. Anterior and lateral chest X-ray is the first examination choice. Tracheoesophageal fistula is the most common serious complication.
Male
;
Female
;
Child
;
Humans
;
Infant
;
Child, Preschool
;
Tracheoesophageal Fistula/etiology*
;
Retrospective Studies
;
Foreign Bodies/diagnosis*
;
Eating
3.Effect of muscle relaxants on the prognosis of neonates with congenital esophageal atresia-tracheoesophageal fistula after surgery.
Wen-Wen HE ; Jing-Wen WENG ; Shi-Xiao DONG ; Fei JIN ; Hai-Lan WU ; Ming-Yan HEI
Chinese Journal of Contemporary Pediatrics 2021;23(7):735-738
OBJECTIVE:
To summarize the experience in the application of muscle relaxants in the perioperative period in neonates with congenital esophageal atresia-tracheoesophageal fistula (EA-TEF).
METHODS:
A retrospective analysis was performed on the medical data of 58 previously untreated neonates with EA-TEF who were treated in the Neonatal Center of Beijing Children's Hospital, Capital Medical University from 2017 to 2019. The incidence rate of anastomotic leak was compared between the neonates receiving muscle relaxants for different durations after surgery (≤ 5 days and > 5 days). The correlation between the duration of postoperative use of muscle relaxants and the duration of mechanical ventilation was evaluated.
RESULTS:
Among the 58 neonates with EA-TEF, 44 underwent surgery, among whom 35 with type III EA-TEF underwent thoracoscopic surgery. Among these 35 neonates, 30 (86%) received muscle relaxants after surgery, with a median duration of 4.75 days, and 6 (18%) experienced anastomotic leak. There was no significant difference in the incidence rate of anastomosis leak between the ≤ 5 days and > 5 days groups (
CONCLUSIONS
Prolonged use of muscle relaxants after surgery cannot significantly reduce the incidence of anastomotic leak, but can prolong the duration of invasive mechanical ventilation in neonates with EA-TEF. Therefore, prolonged use of muscle relaxants is not recommended after surgery.
Child
;
Esophageal Atresia/surgery*
;
Humans
;
Infant, Newborn
;
Muscles
;
Postoperative Complications/etiology*
;
Prognosis
;
Retrospective Studies
;
Tracheoesophageal Fistula/surgery*
;
Treatment Outcome
6.Communicating Bronchopulmonary Foregut Malformation Type III with Pulmonary Sequestration Diagnosed in a Newborn: A Case Report
Su Kyung KIM ; Jin Wha CHOI ; Hong Kwan KIM ; Se In SUNG ; Yun Sil CHANG ; Won Soon PARK
Neonatal Medicine 2019;26(4):223-228
Communicating bronchopulmonary foregut malformation (CBPFM) is a communication between the respiratory and gastrointestinal tracts that can be difficult to differentiate from pulmonary sequestration or H-type tracheoesophageal fistula (TEF) because of the similarities in clinical features. A female neonate born at full term had been experiencing respiratory difficulty during feeding from the third day of life. The esophagography performed to rule out H-type TEF revealed that the esophageal bronchus directly communicated with the left lower lobe (LLL) of the lung. Lobectomy of the LLL, fistulectomy of the esophagobronchial fistula, and primary repair of the esophagus were performed. Finally, CBPFM type III with pulmonary sequestration was confirmed on the basis of the postoperative histopathological finding. We report the first newborn case of CBPFM type III with pulmonary sequestration in Korea.
Bronchi
;
Bronchial Fistula
;
Bronchopulmonary Sequestration
;
Esophagus
;
Female
;
Fistula
;
Gastrointestinal Tract
;
Humans
;
Infant, Newborn
;
Korea
;
Lung
;
Tracheoesophageal Fistula
7.Esophageal Reconstruction with Gastric Pull-up in a Premature Infant with Type B Esophageal Atresia.
Young Mi HAN ; Narae LEE ; Shin Yun BYUN ; Soo Hong KIM ; Yong Hoon CHO ; Hae Young KIM
Neonatal Medicine 2018;25(4):186-190
Esophageal atresia (EA) with proximal tracheoesophageal fistula (TEF; gross type B) is a rare defect. Although most patients have long-gap EA, there are still no established surgical guidelines. A premature male infant with symmetric intrauterine growth retardation (birth weight, 1,616 g) was born at 35 weeks and 5 days of gestation. The initial diagnosis was pure EA (gross type A) based on failure to pass an orogastric tube and the absence of stomach gas. A “feed and grow” approach was implemented, with gastrostomy performed on postnatal day 2. A fistula was detected during bronchoscopy for recurrent pneumonia; thus, we confirmed type B EA and performed TEF excision and cervical end esophagostomy. As the infant's stomach volume was insufficient for bolus feeding after reaching a body weight of 2.5 kg, continuous tube feeding was provided through a gastrojejunal tube. On the basis of these findings, esophageal reconstruction with gastric pull-up was performed on postnatal day 141 (infant weight, 4.7 kg), and he was discharged 21 days postoperatively. At 12 months after birth, there was no catch-up growth; however, he is currently receiving a baby food diet without any complications. In patients with EA, bronchoscopy is useful for confirming TEF, whereas for those with long-gap EA with a small stomach volume, esophageal reconstruction with gastric pull-up after continuous feeding through a gastrojejunal tube is worth considering.
Body Weight
;
Bronchoscopy
;
Diagnosis
;
Diet
;
Enteral Nutrition
;
Esophageal Atresia*
;
Esophagostomy
;
Fetal Growth Retardation
;
Fistula
;
Gastrostomy
;
Humans
;
Infant
;
Infant, Newborn
;
Infant, Premature*
;
Male
;
Parturition
;
Pneumonia
;
Pregnancy
;
Stomach
;
Tracheoesophageal Fistula
8.Successful Management of Acquired Tracheomalacia of Patients With Amyotrophic Lateral Sclerosis: A Report of Three Cases.
Jung Hyun YANG ; Tae Wan KIM ; Byeong Ju LEE ; Jin A YOON ; Myung Jun SHIN ; Yong Beom SHIN
Annals of Rehabilitation Medicine 2018;42(2):368-371
Tracheomalacia is characterized by weakness of the tracheal walls and supporting cartilage. It results in dynamic compression of the airway, where the cross-sectional area of the trachea is reduced by expiratory compression. Acquired tracheomalacia results from complications associated with the use of endotracheal or tracheostomy tubes. In this report, we present three cases of patients with amyotrophic lateral sclerosis (ALS) successfully treated for tracheomalacia, including one case where the patient underwent surgery for combined tracheoesophageal fistula. We discuss the appropriate management strategies for tracheomalacia in patients with ALS. Through these case reports, we note the results of ALS patients who will have tracheostomy, and who are therefore at risk of sustaining a long term high cuff pressure, this study provides an evaluation for tracheomalacia and therapeutic management which should be considered for improving patient care outcomes.
Amyotrophic Lateral Sclerosis*
;
Cartilage
;
Humans
;
Patient Care
;
Trachea
;
Tracheoesophageal Fistula
;
Tracheomalacia*
;
Tracheostomy
9.A Novel MYCN Variant Associated with Intellectual Disability Regulates Neuronal Development.
Xiuya YU ; Liyuan HU ; Xu LIU ; Guodong ZHAN ; Mei MEI ; Huijun WANG ; Xiaohua ZHANG ; Zilong QIU ; Wenhao ZHOU ; Lin YANG
Neuroscience Bulletin 2018;34(5):854-858
Animals
;
Brain
;
growth & development
;
Child
;
Eyelids
;
abnormalities
;
Female
;
Humans
;
Intellectual Disability
;
genetics
;
Limb Deformities, Congenital
;
genetics
;
Mice
;
Microcephaly
;
genetics
;
Mutation, Missense
;
N-Myc Proto-Oncogene Protein
;
genetics
;
Tracheoesophageal Fistula
;
genetics
10.A successful pregnancy outcome in a case of maternal VACTERL
Dominique Joyce M. Concepcion ; Ma. Cristina Pelaez-Crisologo
Philippine Journal of Obstetrics and Gynecology 2018;42(2):35-39
Vertebral anomalies-anal atresia-cardiac abnormalities-tracheoesophageal fistula-renal agenesis-limb (VACTERL) defects association is a rare congenital disease. While most scientific literature focus on the clinical presentation and management of pediatric patients with this condition, this paper focuses on the challenges faced by a 22-year-old primigravid, who was able to carry a pregnancy to term, despite the many anomalies associated with being afflicted with VACTERL.
Humans
;
Tracheoesophageal Fistula
;
VACTERL association
;
Limb Deformities, Congenital


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