Esophageal Motor Dysfunction in an Adult With a Congenital Tracheoesophageal Fistula

Gundry, Steven R.

doi:10.1001/archsurg.1985.01390330088019

Cited by 21 publications

(6 citation statements)

References 4 publications

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“…Gundry and Orringer found similar postrepair esophageal motor dysfunction in a patient without esophageal atresia (congenital H-type fistula) to those with atresia [13]. A lack of peristalsis in the esophageal body and a weak lower esophageal sphincter with incomplete relaxation were characteristically seen with or without esophageal atresia.…”

Section: Discussionmentioning

confidence: 78%

Esophageal motility in an adult with a congenital H-type tracheoesophageal fistula

1990

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Congenital H-type tracheoesophageal fistulas (TEF) are rare. Long-standing respiratory symptoms are the most common presenting complaints. Patients with these fistulas have a congenital esophageal motor abnormality characterized by uncoordinated, low-amplitude peristalsis of the esophageal body; both low and normal lower esophageal sphincter pressures have been described. These findings persist despite fistula repair. A case history of an adult patient with congenital TEF is presented and the literature is reviewed. This patient is unusual in that esophageal symptoms (dysphagia) were more prominent than the usual respiratory symptoms.

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Section: Discussionmentioning

confidence: 78%

Esophageal motility in an adult with a congenital H-type tracheoesophageal fistula

1990

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“…Almost all the patients have postoperative absence of peristalsis in at least one segment of their esophagus (12). This absence, in conjunction with weakness of the lower esophageal sphincter, are commondenominators in patients without esophageal atresia (congenital Htype) (13). In contrast, association of achalasia or lack of relaxation of the lower esophageal sphincter, with TEFis extremely rare; there have been reports of this association in benign and malignant esophageal conditions (14-16).…”

Section: Discussionmentioning

confidence: 99%

Unilateral Bronchiectasis and Esophageal Dysmotility in Congenital Adult Tracheoesophageal Fistula.

Behnia

Tarver

2001

Intern. Med.

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Tracheoesophageal fistulas (TEF) in adults are most commonly neoplastic, and very rarely congenital in nature. We report a 45-year-old Hispanic male with TEFand initial presentation of minimal hemoptysis. The patient had radiographic evidence of unilateral upper lobe (RUL) bronchiectasis, massive esophageal dilatation, and dysmotility. However,there was no evidence of esophageal malignancy, achalasia, or Chagas' disease. Bronchoscopy revealed a large TEF in the posterior wall of trachea, which was not visualized on esophagramor esophagoscopy.Bronchoalveolar lavage (BAL) cultures grew Mycobacterium avium complex (MAC).Our report illustrates that idiopathic, or congenital, TEF can be associated with esophageal dysmotility, adulthood bronchiectasis, and atypical mycobacterial superinfection. (Internal Medicine 40: 620-623, 2001)

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“…demonstrated anomalies in the course and branching pattern of the vagus nerves, deficient extrinsic nerve fiber plexus in the lower esophagus, and intramural nervous abnormalities both excitatory and inhibitory . Further evidence of primary dysmotility come from manometry studies performed preoperatively that demonstrated abnormal motility in newborn with EA and in patients prior to isolated trachea‐esophageal fistula . Evidence of abnormal gastric motility has also been found in EA patients …”

Section: Pathophysiology Of Esophageal Dysmotility In Eamentioning

confidence: 99%

“…23 Further evidence of primary dysmotility come from manometry studies performed preoperatively that demonstrated abnormal motility in newborn with EA 8 and in patients prior to isolated trachea-esophageal fistula. [24][25][26] Evidence of abnormal gastric motility has also been found in EA patients. 27 Extensive mobilization and denervation of the esophagus during EA repair 28 is another mechanism that can affect the esophagus motor function.…”

Section: Pathophysiology Of Esophageal Dysmotility In Eamentioning

confidence: 99%

Esophageal dysmotility: characterization and pathophysiology

Aspirot

Fauré

2013

Dis Esophagus

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Esophageal dysmotility is a considerable long-term issue in patients born with esophageal atresia (EA). To better characterize it, the normal esophageal motility is briefly reviewed with emphasis on the specific defects in EA. Multiple studies attempted to describe the dysmotility seen in patients with operated EA using esophageal manometry. Recently, high-resolution manometry has improved our understanding of normal esophageal motility. Using this new technology, it is now possible to better characterize the esophageal motility of patients operated on for EA. Three different patterns are described and presented: aperistalsis, pressurization, and distal peristalsis. Up to now, it has not been possible to find a correlation between the dysmotility severity and the patient's symptomatology. Different pathophysiological hypotheses of esophageal dysmotility in that population are discussed. Developmental neuronal defects are certainly present from the beginning. Surgical trauma can also contribute to the dysmotility. Finally, defective esophageal acid clearance capacity is a cause of gastroesophageal reflux disease, but the resultant esophagitis can also impair the normal esophageal function. The evolution of esophageal dysmotility in patients with repaired EA is not known and further studies will be necessary to clarify it.

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Esophageal Motor Dysfunction in an Adult With a Congenital Tracheoesophageal Fistula

Cited by 21 publications

References 4 publications

Esophageal motility in an adult with a congenital H-type tracheoesophageal fistula

Esophageal motility in an adult with a congenital H-type tracheoesophageal fistula

Unilateral Bronchiectasis and Esophageal Dysmotility in Congenital Adult Tracheoesophageal Fistula.

Esophageal dysmotility: characterization and pathophysiology

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