Atresia of the esophagus in newborns

Atresia is called a congenital defect of natural canals and openings in the body. This pathology can be acquired by their adhesion or congenital absence.

Atresia of the esophagus in children is considered one of the most common anomalies in the development of this organ. Among the variety of the variants described in clinical practice, there is the most common variety. The most common atresia of the esophagus with the formation of the lower tracheoesophageal fistula.

The clinical picture of the condition is sufficiently pronounced. Already in the first hours of life from the nose and mouth of the newborn comes frothy mucus. After sucking, it accumulates again. Against the background of the condition, aspiration pneumonia begins to progress . Feeding a child before making a diagnosis leads to an acceleration of deterioration. At the same time, symptoms of respiratory failure are noted, signs of aspiration pneumonia increase.

Episodes of deterioration have a direct and clear connection with the feeding of the child - the milk begins to pour out through the mouth and nose.

Especially severe condition and progressive deterioration is accompanied by atresia of the esophagus with a wide fistula (lower tracheoesophageal). At the same time due to the presence of a wide australia, a large amount of air enters the digestive tract, and not into the lungs. Against this background, bloating is observed , and gastric contents in large volume in the tracheobronchial tree can also be noted.

Atresia of the esophagus in a newborn usually does not present difficulties for detection. Moreover, the diagnosis can be carried out before the manifestation of symptoms. It is necessary to establish the absence or presence of pathology before the first feeding. For diagnosis, the probing of the esophagus after birth is used. Atresia of the esophagus is diagnosed if the probe does not pass into the stomach, meeting an obstacle from the edge of the gums at 8-12 cm.

Diagnosis is also carried out with the help of Elephant's test. In this case, through the probe, ten milliliters of air are introduced into the esophagus. In the presence of pathology, the introduced air exits with characteristic noise through the mouth and nose back (positive sample). In the absence of anomalies, there is a noiseless passage into the stomach of the air ( negative sample ).

The sounding and sampling of Elephant in the maternity hospital for the diagnosis of pathology is quite enough.

When revealing the first signs of atresia in the esophagus, intubation is necessary to carry out the sanitation of the upper respiratory tract. These measures can reduce the risk of aspiration pneumonia. After carrying out these measures, the patient is transferred to a surgical hospital.

Timely detection (in the first and second days after birth) of the blemish allows eliminating the need for parenteral nutrition in the prehospital period.

Another anomaly of development is atresia of the rectum and anus. The defect is revealed, as a rule, at a primary examination of the newborn. The most common anomaly in boys.

If the examination for any reasons after birth was not performed, by the end of the first day the newborn child begins to worry, with abundant regurgitation, vomiting with gastric contents, after - with bile, then - with meconium. There is gradually developing bloating. Gases and meconiums do not depart.

As a treatment, a one-stage radical operation using the Pen method is used. If there are contraindications to the indicated surgical intervention or the impossibility of its implementation, apply a colostomy.

In the absence of treatment, the newborn dies on the fourth or sixth day.