We present an analysis of 400 intralobar and 133 extralobar sequestrations, six cases presenting intra-and extralobar sequestration simultaneously, five sequestrations of one whole lung, and two bilateral intralobar sequestrations.This anomaly comprises 0 15-6 4% of all congenital pulmonary malformations. Usually the posterior basal segment is affected.The aberrant artery in intralobar sequestration originated in 74% of all cases from the thoracic aorta, and in 14*8% there was more than one anomalous artery. The mean diameter of the aberrant arteries was 643-6 6 mm. Usually arteries with predominantly elastic fibres were found. Arteriosclerotic changes were common, even in children.
ZusammenfassungBericht über eine tracheo-ösophageale Fistel als Komplikation von Langzeitbeatmung. Nach Darstellung der diagnostischen Merkmale wurden Behandlungstaktik und -möglichkeiten dargelegt. Als Therapie der Wahl wird die radikale chirurgische Beseitigung der Fistel, sobald es der Zustand des Patienten erlaubt, vorgeschlagen. Als beste Operationsmethode wird die rechtsseitige Thorakotomie unter Entfernung der 4. Rippe und Bildung eines gestielten Gewebelappens, der aus interkostaler Muskulatur und parietaler Pleura besteht, empfohlen. Nach Verschluß des Defektes am Ösophagus wird dann der Lappen zwischen den beiden Organen interponiert, nach Möglichkeit so, daß die ganze Länge der intrathorakalen Trachea gedeckt wird.
SummaryA case of ulcerative tracheoesophageal fistula following long term respiratory support is described. After establishing the diagnosis of TEF, an attempt at surgical repair should be made as quickly as patient's condition permits it, ideally immediately. We suggest right side thoracotomy with the resection of the fourth rib, thereby facilitating preparation of a pedicled flap which should be interponated between trachea and esophagus after the closure of the esophagus defect by sutures has been performed.
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