Tracheomalacia in oesophageal atresia: morphological considerations by endoscopic and CT study☆

Briganti, Vito; Oriolo, Lucia; Buffa, Vitaliano; Garofalo, Salvatore; Cavallaro, Sebastiano; Calisti, Alessandro

doi:10.1016/j.ejcts.2005.04.003

Cited by 26 publications

(22 citation statements)

References 20 publications

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“…Dynamic fiberoptic bronchoscopy and CT scans allowed us to describe 3 morphological variations of thoracic TM as described in our previous report [7]: (a) anterior TM (ATM) caused by compression of the aorto-innominate complex (Mustard complex); (b) intrinsic TM (ITM), in which signs of vascular imprinting were not evident; and (c) complex malacia (CM).…”

Section: Resultsmentioning

confidence: 98%

Tracheomalacia in esophageal atresia. Usefulness of preoperative imaging evaluation for tailored surgical correction

Briganti

Oriolo

Mangia

et al. 2006

Journal of Pediatric Surgery

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Section: Resultsmentioning

confidence: 98%

Tracheomalacia in esophageal atresia. Usefulness of preoperative imaging evaluation for tailored surgical correction

Briganti

Oriolo

Mangia

et al. 2006

Journal of Pediatric Surgery

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“…23 In addition, the frequency of a right-sided aortic arch in the general population is estimated to be around 0.1%-0.9% and as high as 2.5%-13% in patients with oesophageal atresia. 1,11,23,24 One of our patients presented with partial anomalous pulmonary venous return associated with congenital heart disease and lobar pulmonary agenesis, and five presented with persistent left superior vena cava. The latter has been the most frequently described intrathoracic venous anomaly in the general population (0.3%-2%), with a rate of 10% in patients with congenital heart disease 27 and an even higher frequency in patients with oesophageal atresia.…”

Section: If Laryngotracheal Endoscopy Not Informativementioning

confidence: 96%

“…This involved visualisation of a tracheal compression by the aorto innominate complex. 11 Aortic anomalies were searched for in all cases and were described according to the position of the aortic arch. In patients with contrast-enhanced CTs, we reported cases of arteria lusoria, namely a left arch aberrant right subclavian artery.…”

Section: Patients and Me Thodsmentioning

confidence: 99%

“…7,8 Chest computed tomography (CT) scans of patients with oesophageal atresia are performed in numerous contexts: preoperative evaluations, including assessment before aortopexy, when there are persistent respiratory symptoms and in cases with postoperative complications. [9][10][11] Contrast-enhanced chest CTs provide precise anatomical descriptions of the airways, lung parenchyma and mediastinal vascularisation and can lead to diagnoses of thoracic abnormalities, including tracheobronchial and pulmonary malformations.…”

Section: Introductionmentioning

confidence: 99%

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Bronchopulmonary and vascular anomalies are frequent in children with oesophageal atresia

et al. 2019

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Aim: Oesophageal atresia is frequently associated with other malformations, and our aim was to use computed tomography (CT) to explore intrathoracic malformations in patients with this condition. Method: This was retrospective study of children aged 0-16 with oesophageal atresia who were born in 1996-2013 and followed up at the French reference centre for rare oesophageal diseases at the University of Lille. Computed tomography scans were available for 48 of the 234 patients during follow-up visits, and these were reviewed by a thoracic radiologist. Results: More than two-thirds of the scans were performed to explore persistent respiratory symptoms. We found that six patients had a pulmonary malformations: four lobar agenesis, one right pulmonary aplasia and one congenital cystic adenomatoid malformation. Computed tomography enabled us to diagnose unexpected thoracic malformations in 16 patients: four lobar agenesis, six arteria lusoria, five persistent left superior vena cava and one partial anomalous pulmonary venous return. It also confirmed the diagnoses of suspected malformations in five patients: one congenital cystic adenomatoid malformation, one pulmonary hypoplasia, two right-sided aortic arches and one communicating bronchopulmonary foregut malformation. Conclusion: Intrathoracic anomalies were frequently associated with oesophageal atresia, and contrast-enhanced chest CT scans should be performed on patients with persistent respiratory symptoms.

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“…Persistent nonspecific respiratory symptoms are commonly presented in children with EA, including brassy cough, bronchitis, pneumonia, asthma-like symptoms, and bronchial hyperresponsiveness [ 19 – 23 ]. Developmental abnormalities of tracheal structure and innervation or lung hypoplasia may account for sequelae that persist into childhood [ 3 , 7 , 24 , 25 ]. We previously reported significant underdevelopment of the lungs in experimental EA because of defective embryonic airway branching.…”

Section: Discussionmentioning

confidence: 99%

Impaired FGF10 Signaling and Epithelial Development in Experimental Lung Hypoplasia With Esophageal Atresia

et al. 2018

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Patients with esophageal atresia (EA) and tracheoesophageal fistula (TEF) often experience persistent respiratory tract disease. In experimental models, doxorubicin-induced developmental lung abnormalities may result from downregulation of branching morphogenesis factor fibroblast growth factor (Fgf10). This study investigated the temporospatial expression of Fgf10 pathway components and lung epithelial factors in an doxorubicin-induced EA-TEF model by quantitative polymerase chain reaction, immunohistochemistry, and immunoblotting. Epigenetic regulation of gene expression by histone deacetylation was also investigated. Bone morphogenetic protein (Bmp) 4 and Cathepsin H (Ctsh), downstream targets of Fgf10, were significantly downregulated in the EA-TEF model during the saccular stage, consistent with Fgf10 expression. The developmental expression pattern of P2x7 receptor (ATI-cell marker), Sftpa, and Sftpb in lung epithelial cells was not affected. Sftpc (ATII-cell Marker) and Scgb1a1 (Clara cell marker) were significantly downregulated at the canalicular stage. Meanwhile, histone deacetylase (Hdac) 1 was upregulated and subsequently decreased acetylation of histone H3 Lys56 in the EA-TEF model, which returned to a normal level at the saccular stage. In conclusion, disturbed molecular signaling involving Fgf10/Ctsh was associated with impaired airway branching and epithelial cell development in lung morphogenesis, as evidenced by downregulated Sftpc and Scgb1a1 protein expression. The influence of Hdac1 activity on gene and protein expression in lung epithelial cells deserves further study.

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Tracheomalacia in oesophageal atresia: morphological considerations by endoscopic and CT study☆

Abstract: A correct morphological analysis of the malformed segment permitted 'tailored surgery' for each individual patient, allowing us to take account of the type of malacia, its length, and the compressive action exercised by the mediastinal great vessels.

Cited by 26 publications

References 20 publications

Tracheomalacia in esophageal atresia. Usefulness of preoperative imaging evaluation for tailored surgical correction

Tracheomalacia in esophageal atresia. Usefulness of preoperative imaging evaluation for tailored surgical correction

Bronchopulmonary and vascular anomalies are frequent in children with oesophageal atresia

Impaired FGF10 Signaling and Epithelial Development in Experimental Lung Hypoplasia With Esophageal Atresia

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