Unilateral Bronchiectasis and Esophageal Dysmotility in Congenital Adult Tracheoesophageal Fistula.

Behnia, Mehrdad; Tarver, Robert D.

doi:10.2169/internalmedicine.40.620

Cited by 8 publications

(5 citation statements)

References 14 publications

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“…Bronchiectasis is defined as an abnormal dilatation of the bronchial tree and it is one of the more serious pulmonary complications in patients with EA‐TEF 64,65,111 . A ratio more than 0.8 of the bronchial and arterial lumens in a chest CT is considered diagnostic 49 .…”

Section: Resultsmentioning

confidence: 99%

“…Bronchiectasis: Bronchiectasis is one of the more serious pulmonary complications in patients with EA-TEF. 9,11,42,[64][65][66][67][68][69] Although it is the end-result of other complications (especially recurrent LRTIs and aspiration), it becomes a specific entity by itself, becoming the source of even more infections and causing irreversible damage to the airways. Clinically, it is characterized by daily productive cough (even in the absence of an acute infection).…”

Section: Respiratory Pathophysiologymentioning

confidence: 99%

“…Level A Recommendations Bronchiectasis is defined as an abnormal dilatation of the bronchial tree and it is one of the more serious pulmonary complications in patients with EA-TEF. 64,65,111 A ratio more than 0.8 of the bronchial and arterial lumens in a chest CT is considered diagnostic. 49 The finding of "tramlines" and/or of "signet ring" sign opacities in plain radiographs are typical of bronchiectasis but their absence does not rule out the diagnosis.…”

Section: Evaluation Of Bronchiectasismentioning

confidence: 99%

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Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Koumbourlis

Belessis

Cataletto

et al. 2020

Pediatric Pulmonology

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Tracheoesophageal fistula (TEF) with esophageal atresia (EA) is a common congenital anomaly that is associated with significant respiratory morbidity throughout life. The objective of this document is to provide a framework for the diagnosis and management of the respiratory complications that are associated with the condition. As there are no randomized controlled studies on the subject, a group of experts used a modification of the Rand Appropriateness Method to describe the various aspects of the condition in terms of their relative importance, and to rate the available diagnostic methods and therapeutic interventions on the basis of their appropriateness and necessity. Specific recommendations were formulated and reported as Level A, B, and C based on whether they were based on “strong”, “moderate” or “weak” agreement. The tracheomalacia that exists in the site of the fistula was considered the main abnormality that predisposes to all other respiratory complications due to airway collapse and impaired clearance of secretions. Aspiration due to impaired airway protection reflexes is the main underlying contributing mechanism. Flexible bronchoscopy is the main diagnostic modality, aided by imaging modalities, especially CT scans of the chest. Noninvasive positive airway pressure support, surgical techniques such as tracheopexy and rarely tracheostomy are required for the management of severe tracheomalacia. Regular long‐term follow‐up by a multidisciplinary team was considered imperative. Specific templates outlining the elements of the clinical respiratory evaluation according to the patients’ age were also developed.

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Section: Resultsmentioning

confidence: 99%

Section: Respiratory Pathophysiologymentioning

confidence: 99%

Section: Evaluation Of Bronchiectasismentioning

confidence: 99%

See 1 more Smart Citation

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Koumbourlis

Belessis

Cataletto

et al. 2020

Pediatric Pulmonology

View full text Add to dashboard Cite

show abstract

“…Bronchiectasis is one of the more serious pulmonary complications in patients with EA-TEF 9,11,43,[65][66][67][68][69][70] . Although it is the end-result of other complications (especially recurrent LRTIs and aspiration), it becomes a specific entity by itself, becoming the source of even more infections and causing irreversible damage to the airways.…”

Section: Bronchiectasismentioning

confidence: 99%

Care Recommendations for the Respiratory Complications of Esophageal Atresia-Tracheoesophageal Fistula: The International Network of Esophageal Atresia, Respiratory Complications Working Group

Koumbourlis

Belessis

Cataletto

et al. 2020

Preprint

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Tracheoesophageal fistula (TEF) with esophageal atresia (EA) is a common congenital anomaly that is associated with significant respiratory morbidity throughout life. The objective of this document is to provide a framework for the diagnosis and management of the respiratory complications that are associated with the condition. As there are no randomized controlled studies on the subject, a group of experts used a modification of the Rand Appropriateness Method to describe the various aspects of the condition in terms of their relative importance, and to rate the available diagnostic methods and therapeutic interventions on the basis of their appropriateness and necessity. Specific recommendations were formulated and reported as Level A, B, C based on whether they were based on "strong", "moderate" or "weak" agreement. The tracheomalacia that exists in the site of the fistula was considered the main abnormality that predisposes to all other respiratory complications due to airway collapse and impaired clearance of secretions. Aspiration due to impaired airway protection reflexes is the main underlying contributing mechanism. Flexible bronchoscopy is the main diagnostic modality, aided by imaging modalities, especially CT scans of the chest. Non-invasive positive airway pressure support, surgical techniques such as tracheopexy and rarely tracheostomy are required for the management of severe tracheomalacia. Regular long-term follow-up by a multidisciplinary team was considered imperative. Specific templates outlining the elements of the clinical respiratory evaluation according to the patients' age were also developed.

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“…Using CT scanning, rates of bronchiectasis in EA/TEF survivors may be as high as 27% (4, 55). While neither DeBoer et al (4) nor Cartabuke et al (60) examined potential associations with bronchiectasis (59), bronchiectasis in this population has generally been associated with massive aspiration, including patients with gastric or colonic interposition in a selected referral population (22), longstanding GERD (61), massive TEF pouch secretions, trisomy 21 (62), undiagnosed TEF (63), or broncho-esophageal fistula (64, 65). …”

Section: Associations With Respiratory Morbidity In Patients With Repmentioning

confidence: 99%

Aspiration Risk and Respiratory Complications in Patients with Esophageal Atresia

Kovesi

2017

Front. Pediatr.

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Chronic, long-term respiratory morbidity (CRM) is common in patients with a history of repaired congenital esophageal atresia, typically associated with tracheoesophageal fistula (EA/TEF). EA/TEF patients are at high risk of having aspiration, and retrospective studies have associated CRM with both recurrent aspiration and atopy. However, studies evaluating the association between CRM in this population and either aspiration or atopy have reported conflicting results. Furthermore, CRM in this population may be due to other related conditions as well, such as tracheomalacia and/or recurrent infections. Aspiration is difficult to confirm, short of lung biopsy. Moreover, even within the largest evidence base assessing the association between CRM and aspiration, which has evaluated the potential relationship between gastroesophageal reflux and asthma, findings are contradictory. Studies attempting to relate CRM to prior aspiration events may inadequately estimate the frequency and severity of previous aspiration episodes. There is convincing evidence documenting that chronic, massive aspiration in patients with repaired EA/TEF is associated with the development of bronchiectasis. While chronic aspiration is likely associated with other CRM in patients with repaired EA/TEF, this does not appear to have been confirmed by the data currently available. Prospective studies that systematically evaluate aspiration risk and allergic disease in patients with repaired EA/TEF and document subsequent CRM will be needed to clarify the causes of CRM in this population. Given the prevalence of CRM, patients with repaired EA/TEF should ideally receive regular follow-up by multidisciplinary teams with expertise in this condition, throughout both childhood and adulthood.

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Unilateral Bronchiectasis and Esophageal Dysmotility in Congenital Adult Tracheoesophageal Fistula.

Cited by 8 publications

References 14 publications

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Care Recommendations for the Respiratory Complications of Esophageal Atresia-Tracheoesophageal Fistula: The International Network of Esophageal Atresia, Respiratory Complications Working Group

Aspiration Risk and Respiratory Complications in Patients with Esophageal Atresia

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