Anesthetic Consideration on Neonatal Patient with Esophageal Atresia

Abstract

Esophageal atresia is a disorder of the esophageal continuity with or without a connection with the trachea or the under-development esophagus. Most babies who suffer from esophageal atresia also have tracheoesophageal fistula (an abnormal connection between the esophagus and the trachea/windpipe). The possibility of these two conditions is accompanied by other anomalies such as congenital heart disease and anorectal malformations. Esophageal atresia can also be interpreted as malformations caused by the failure of the esophagus to develop a continual passage that may or may not establish a connection to the trachea (tracheoesophageal fistula) or it can be said that the esophageal atresia is the failure of the esophagus to form a channel from the pharynx to the stomach during embryonic development. Another understanding of esophageal atresia is an interruption in the growth of a segment of the esophagus and remains as thin sections without continual channels. Tracheal esophageal fistula is an abnormal connection between the trachea and esophagus. Miscellaneous types of esophageal atresia include: Type A. The incidence of Type A esophageal atresia was about 5% -8%. Type A esophageal atresia occurs at each end of the esophageal sac, and is apart without fistula to the trachea. Type B incident is rare. Type B esophageal atresia occurs at each end of the esophagus, and there is fistula from the trachea to the upper segment of esophagus. Incidence of Type C esophageal atresia occurs about 80% -95%. Type C esophageal atresia occurs at the proximal esophageal segment and ends at a dead-end sac, and distal segments are connected to the trachea or primary bronchus. Type D esophageal atresia is rare. In this type, upper and lower segment of the esophagus is connected to the trachea. Type E esophageal atresia is rare when compared with Types A and C esophageal atresia. In this type the esophagus and trachea are normal but they are connected with fistula.

Management Anesthesia of Esophagostomy in a Patient with a Double Outlet Right Ventricle

“…Fetuses with atresia esophagus cannot swallow amniotic fluid effectively. 7 In fetus with atresia esophagus and TEF in distal location, amniotic fluid will flow to the trachea, fistula, and then into the intestine. This condition result is the polyhydramnios condition.…”

“…10 This condition can lead to perforation of the gaster, which is often fatal. 7 Studies on manometer manipulation of the esophagus have shown that the distal esophagus is often dysmotility, with poor peristalsis or peristalsis. This will lead to varying degrees of dysphagia after continuous manipulation of esophageal reflux.…”