Twenty children, ranging in age from 1--9 years, and one adult suffering from epiglottis acuta were treated with nasotracheal intubation performed under general anaesthesia and with ampicillin. Clinical cure was obtained in all cases with a mean intubation time of 34 hours. The diagnosis, epiglottis acuta, was suspected by the referring physician in 10 cases. The incidence of epiglottis acuta compared to laryngitis acuta was found to be 1:30. The mean hospital stay was 5.4 days. It is concluded that treatment of acute epiglottis by nasotracheal intubation in the hands of experienced anaesthesiologists and with close observation in an intesnive care unit, is a safe method of management with negligible morbidity and mortality.
Congenital tracheo-oesophageal fistula without atresia can persist and remain undetected until adulthood. We present such a case and give a review of the literature. Symptoms are commonly present during infancy, but to confirm diagnosis of a fistula is often exceedingly difficult. We visualized the fistula in our case by means of a bronchofibrescope when all the other available tests had failed. The speculations as to how these patients reach adult life have been many, but we consider that we have found an important and hitherto undescribed answer to this question, namely a sphincter mechanism in the fistula.
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