Esophagotracheal fistula

Introduction The respiratory organs from the trachea to the alveoli begin with a sulcus (the lung gro-ove) from the ventral side wall of the foregut (later developed into the esophagus). At some later time, the esophageal tracheal septum extending from the rear with the opening between the esophagus and the trachea is completely blocked, leaving only the throat portion. If the insufficiency is not complete, a port between the tracheal esophagus is left in the area outside the throat, which is called the esophageal tracheal fistula.

Cause

Both the esophagus and the respiratory tract originate from the foregut of the embryonic gut in the process of development. The original esophagus is located behind the respiratory organs. The original intestine is divided into three parts: the foregut, the midgut and the hindgut. In the early stages, the cephalic and caudal sides of the gut were locked. At the end of the third week of embryogenesis, the pharyngeal membrane on the side of the original intestine ruptured, allowing the foregut to communicate with the ostium. As the heart shifts downward, the length of the esophagus increases rapidly. On the 21st to 26th day of embryogenesis, the larynx tracheal groove appears on both sides of the foregut, and then the epithelium grows to form the esophageal tracheal septum, separating the esophagus from the trachea. If the esophagus and the trachea are not completely separated, the lumens of the two can form an esophageal tracheal fistula.

an examination

Related inspection

Tracheal aspiration esophagography

Esophageal atresia occurs when the esophageal trachea is displaced backwards or the foregut epithelium grows excessively into the esophageal lumen. In addition, in the early stage of esophageal development, part of the foregut cells are separated from the esophagus and continue to grow, which can form esophageal repetitive malformations, most of which are cysts close to the esophageal wall, and some cysts communicate with the esophageal lumen.

Differential diagnosis

Differential diagnosis of esophageal tracheal fistula:

1, congenital esophageal tracheal fistula: usually found in newborns, but congenital esophageal tracheal fistula can not be diagnosed until adolescents or even adults. Most cases have a history of long-term feeding cough or cough, often coughing out food particles, and occasionally with bronchiectasis.

2, acquired esophageal tracheal fistula: the most common cause of abnormal airway and esophageal traffic is esophageal cancer, some cases can occur after radiotherapy, the incidence of up to 5.3%. Once this complication occurs, the prognosis is extremely poor and most cases die within weeks or months. Acquired tracheal-esophageal fistula can also be caused by tracheal balloon compression of the trachea, surgical trauma, blunt injury, and foreign bodies. CT examination can be used to confirm the diagnosis of fiberoptic bronchoscopy and swallowing.

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