Vascular and pulmonary comorbidities in children with congenital EA/TEF
| Autor: | Thomas S. Poore, Sparrow Helland, Jeremy D. Prager, Natalie Antoniolli, Joel A. Friedlander, Stig Somme, Jason P. Weinman, Emily M. DeBoer, Benjamin Corbett, Todd Wine, Elyse Handley |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Tracheoesophageal fistula Comorbidity 03 medical and health sciences 0302 clinical medicine Bronchoscopy 030225 pediatrics medicine Humans Vascular Diseases Respiratory system Child Esophageal Atresia Lung Bronchiectasis medicine.diagnostic_test business.industry medicine.disease Trachea medicine.anatomical_structure 030228 respiratory system Tracheomalacia Child Preschool Atresia Pediatrics Perinatology and Child Health Angiography Female Radiology Tomography X-Ray Computed business Tracheoesophageal Fistula Artery |
| Zdroj: | Pediatric Pulmonology. 56:571-577 |
| ISSN: | 1099-0496 8755-6863 |
| DOI: | 10.1002/ppul.25219 |
| Popis: | Background Esophageal atresia with tracheoesophageal fistula (EA/TEF) is associated with many congenital and vascular malformations, however reports utilizing computed tomography (CT) and CT angiography (CTA) are limited. The objective of this study was to review CT scans of the chest from patients with EA/TEF and report their pulmonary and vascular findings. Methods We completed a retrospective chart review of children with congenital EA/TEF evaluated in the aerodigestive clinic at Children's Hospital Colorado. Results of the most recent CTA or CT of the chest were investigated. Demographics, medical conditions, and bronchoscopy findings were also recorded. Ratio of tracheal lumen area between inspiratory and expiratory CTA images was measured. Results Of the patients with congenital EA/TEF seen in the program, 47 patients had a chest CT available for review. Eight patients (17%) had bronchiectasis. Of the contrast CT scans, 15 (58%) had a vascular abnormality and 16 (62%) demonstrated tracheal compression (38% at the level of the innominate artery, 35% from other structures). Nineteen of the CTAs had volumetric expiratory images of the trachea to evaluate tracheomalacia. The mean expiratory:inspiratory area was 0.57 (SD +/- 0.23) at the level of the innominate. Conclusion Patients with EA/TEF frequently have vascular abnormalities that may alter airway mechanics as well as pulmonary comorbidities that may affect long term management. For patients experiencing persistent respiratory symptoms, CTA of the chest should be considered adjunct to bronchoscopy to help with medical and surgical management of these children. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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