Esophageal Atresia with Tracheoesophageal Fistula | ESCON | E-Learning скачать в хорошем качестве

Esophageal Atresia with Tracheoesophageal Fistula | ESCON | E-Learning

Mrs.A.S.Malathi, Assistant Professor, Department of Child Health Nursing, E.S College of Nursing, Villupuram, Tamilnadu _______________________________________________ TOPIC: Esophageal Atresia with Tracheoesophageal Fistula Oesophageal atresia (EA) is a failure of oesophagus to form a continuous passage from the pharynx to the stomach during the embryonic development. TEF is an abnormal connection between trachea and oesophagus. Approximately 1 in 3000-4500 lives births. Occurs about equally in males and females. Approximately 30-50 percent of infants with EA have other congenital anomalies. The Etiological factors: maternal alcohol and smoking, Exposure to methimazole, prolonged mechaincal ventilation, maternal polydramnious and Maternal DM. Types: 1.Esophageal Atresia without TEF 2.EA with Proximal TEF 3.EA with Distal TEF 4.EA with both Proximal and Distal TEF and 5.H Type TEF The Clinical features: Coughing, Chocking, and Cyanosis, Drooling of saliva, Respiratory distress, Regurgitation, Abdominal distension, Aspiration pneumonia and Laryngo spasm. Diagnostic Evaluation: Antenatal diagnosis of condition by USG, Ultrasonography, Plain X ray abdomen, Chest X ray, passing of radio opaque catheter through esophagus Bronchoscopy and ECG. Immediate management: Propped up position, Nil per oral, Airway clearance, Oxygen therapy, IV fluid therapy, Naso gastric tube aspiration and Gastrostomy. Staging Surgery: First Stage: TEF is ligated and gastrostomy , Second Stage: Proximal and distal segment is anastomosed. if the gap was too large, a segment of colon is used for reconstruction. It is done about 18 to 24 months. Other surgical management: Cervical esophagotomy:, Esophago-coloplasty: Esophagus replaced by a segment of intestine is done at 18 to 24 months, Esophago-gastroplasty Complications: Anastigmatic leak, Dysphagia, Esophageal stricture, Gastroesophageal reflux disease, recurrent pneumonia, Chest wall deformity and Tracheo malacia Nurse’s responsibility: Airway clearance, Maintaining nutrition and prevention of aspiration, Preventing infection, Minimizing pain and reducing anxiety