• Journal of Chest Surgery
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• v.5 no.2
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• pp.153-158
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• 1972

The esophageal atresia with tracheoesophageal fistula occurs approximately once in 3, 000 live births. In Korea, about 20 cases were reported with five successful surgical corrections. The atresia characteristically occurs at the level of, or just cephalad to, the carina and is associated with a tracheoesophageal fistula. In about 90% of the cases, the upper esophagus ends in a blind pouch, and the lower esophageal segment communicates with the trachea through the membranous posterior wall just above the carina. Many of the Infants with esophageal atresia have other congenital anomalies. The most common of these are congenital cardiac anomalies, imperforate anus, genitourinary malformations, and intestinal atresia. Recently we experienced four cases of esophageal atresia, of which three were Gross type C and one was type A. Two of them were treated by primary repair, and one [type A] was taken cervical esophagostomy and gastrostomy. The another was refused surgery.

• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.729-734
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• 1999

Broncho-esophageal fistula(BEF) is an uncommon clinical entity which can cause severe suppurative lung disease. Acquired fistulas between the esophagus and tracheobronchial tree are relatively uncommon. They are caused by many diseases including malignancy and chronic inflammation such as tuberculosis and have favorable outcome with proper treatment To our knowledge, there has been no description of patients with BEF due to the bronchiectasis. We report a case of broncho-esophageal fistula in association with bronchiectasis in a 35-year-old male patient with hemoptysis. Bronchoscopy revealed mild bleeding from the superior segment of the right lower lobe without specific endobronchial lesion. Barium esophagogram could not confirm the fistula. The diagnosis of a broncho-esophageal fistula was established by an esophagogastroscopy using fistulogram and subsequent bronchoscopy, in which the communication between the bronchial tree and the esophagus was demonstrated by instilling dye selectively through the fistulous opening using esophagogastroscopy and visualizing the fistula and the bronchial tree. The patient was treated with resection of the right lower lobe, extirpation of the diverticulum and surgical closure of the bronchial defect and fistula, but he suffered from pneumonia thereafter and eventually expired due to sepsis and multiple organ failure.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.1
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• pp.28-33
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• 2013

Purpose: Anorectal malformations are often associated with other anomalies, reporting frequency with 40-70%. Gastrointestinal anomalies have been known to be relatively less common than associated anomalies of other organ system. This study was performed to assess a distinctive feature of cases associated with esophageal atresia. Methods: Clinical data (from January 2000 through December 2011) on the 196 subjects with anorectal malformations, managed in our Hospital, were reviewed. Total 14 neonates were identified with accompanying esophageal atresia and retrospective analysis was conducted. Results: The incidence was 7.1% and there were 8 male and 6 female subjects. Only 2 cases were associated with esophageal atresia without tracheoesophageal fistula. Although variable cases of anorectal malformation in female subjects, almost cases were anorectal malformations with rectourethral fistula in male. Other associated anomalies were identified in all cases, with more than 3 anomalies in 10 cases. There were 4 VACTERL (Vertebral abnormalities, Anal atresia, Cardiac anomalies, Tracheoesophageal fistula, Esophageal atresia, Renal and Limb anomalies) associations accounting for 28.6%, but could not identify chromosomal anomaly. Most cases were managed with staged procedure, usually primary repair of esophageal atresia and diverting colostomy. Overall mortality rate was 21.4%, mainly caused by heart problems. Conclusion: This study shows that early diagnosis and rational surgical approach with multidisciplinary plan are mandatory in managing anorectal malformations with esophageal atresia, when considering a high frequency of associated anomaly and a relative high mortality.

• Advances in pediatric surgery
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• v.1 no.2
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• pp.162-169
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• 1995

Since 1988, we have performed esophageal replacement with the reversed gastric tube on four esophageal atresia patients. Three patients had long-gap esophageal atresias and one patient had recurrent tracheoesophageal fistula that was previously operated on three times. One combined imperforate anus. The youngest patient was 6-month-old and the oldest, 34-month-old at the time of procedure. The technique of gastric tube construction is described. There have been both major and minor complications. Although two patients had shown distal tube strictures as late complications. those were solved with tuboplasties on 29 months and 48 months, postoperatively. Growth and development have been acceptable in all four patients, although most remain in the lower percentiles for growth and height, a condition that usually predates the esophageal substitution. Conclusively, reversed gastric tube interposition has proved very satisfactory for long-gap esophageal atresia that cannot be anastomosed primarily even by spiral myotomy and esophageal atresia with recurrent tracheoesophageal fistula having destroyed esophagus due to previous operation.

• Advances in pediatric surgery
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• v.14 no.1
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• pp.1-11
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• 2008

The aim of this study is to analyze the outcomes of the esophageal atresia with tracheoesophageal fistula over the last 2 decades. The records of 51 patients born between 1987 and 2006 were reviewed. Twenty-seven patients were male. Mean values of the age, gestational age and birth weight were 2.9 days, 296 days and 2.7kg, respectively. All patients had Gross type C anomalies. Thirty-one patients (60.7 %) had one or more associated congenital anomalies and the most common anomaly was cardiac malformation. In 48 cases, primary anastomosis was done and staged operation was done in one case. Circular myotomies in the proximal esophagus were performed in 9 cases. Postoperative complication developed in 26 cases (54 %): pulmonary complication in 12 cases, anastomotic leakage in 10 and anastomotic stricture in 10, recurrent trachoesophageal fistula in one and tracheomalasia in 2 cases. Reoperation was carried out in 2 patients with anastomotic leaks, the remaining leaks were managed non operatively. Three of the strictures were reoperated upon and the others were successfully managed by balloon dilatations. Overall mortality rate was 15.6 %. Mortality rate of the second 10 years (8 %) period decreased significantly compared to that of the first 10 years (23 %) period.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1275-1279
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• 1990

Esophagopleural fistula is a rare complication that should be suspected in all patients with recurrent empyema following pneumonectomy and in whom a bronchopleural fistula can be excluded. In late postpneumonectomy esophagopleural fistula, diagnosis is difficult due to its rarity and no specific symptom and sign, but we have experienced a man who had suffered dysphagia and odynophagia. In surgical treatment of late postpneumonectomy esophageal fistula, closure of empyema space is of prime importance. We have adopted a type of latissimus dorsi muscle and serratus anterior muscle flap transposition We present here this technique and result obtained in patient with late postpneumonectomy esophagopleural fistula.

• Journal of Chest Surgery
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• v.24 no.3
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• pp.306-309
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• 1991

Esophageal perforation by a ingested coins is a rare but usually life threatening complication, particularly if there is a delay in their removal. We report a case of esophageal perforation which occurred in a 4-year-old child after ingestion of a coin. The coin was removed through a left cervical esophagostomy approach. A gastrograffin study of the esophagus, performed four days after surgery, revealed the fistula had reopened. The wound was reexplored and the fistula was closed again with some debridement. In spite of the procedure, there had been continuous drainage of the saliva through the cervical fistula of esophagus. However within three weeks of conservative management, aided by a local drainage and hyperalimentation, the fistula of the esophagus was closed spontaneously.

• Korean Journal of Bronchoesophagology
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• v.9 no.2
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• pp.65-68
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• 2003

Recently we successfully treated two cases of congenital bronchoesophageal fistula(BEF), communicating esophagus and right lower lobe, in adults by fistulectomy and right lower lobectomy. The fistulas were initially diagnosed on chest CT examination and confirmed by endoscopy and esophagography. The diagnosis of BEF is usually made by barium esophagography, esophagoscopy, and bronchoscopy. Although congenital BEF presented in adult life is a rare disorder, careful examination of chest CT films would disclose more cases of it , we think , than expected.

• Journal of Chest Surgery
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• v.3 no.1
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• pp.21-24
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• 1970

The congenital esophageal atresia with tracheoesophageal fistula has been reported only 15 cases up to date in Korea, but this might be the first cases that was operated on successfully. A five day old male infant underwent the Haight`s operation on Nov-l,1968. The diagnosis was made by the esophagography and the operation was performed transpleurally through the right fifth intercostal space and the Stamm`s feeding gastrostomy was made on at the same time. The post-operative course has been uneventful until now. A literature review was done in this subject.

• Journal of Chest Surgery
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• v.20 no.3
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• pp.619-623
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• 1987

We experienced a surgical case of esophageal atresia and tracheoesophageal fistula combined with imperforated anus, tracheal bronchus in a one day baby. A vacuum delivered full term baby, weighing 4.1 Kg showed grunting respiration, repeated regurgitation and distended abdomen after birth. Esophagogram revealed markedly dilated proximal esophagus as blind pouch and also noted displaced type of tracheal bronchus of right upper lobe by incidental bronchogram. Surgical correction with Haight anastomosis was performed successfully on the second day.