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Respiratory problems in children with esophageal atresia and tracheoesophageal fistula

BACKGROUND: Children with congenital esophageal atresia (EA) and tracheoesophageal fistula (TEF) have chronic respiratory symptoms including recurrent pneumonia, wheezing and persistent cough. The aim of this study is to describe the clinical findings of a large group of children with EA and TEF sur...

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Autores principales: Porcaro, Federica, Valfré, Laura, Aufiero, Lelia Rotondi, Dall’Oglio, Luigi, De Angelis, Paola, Villani, Alberto, Bagolan, Pietro, Bottero, Sergio, Cutrera, Renato
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5584000/
https://www.ncbi.nlm.nih.gov/pubmed/28870218
http://dx.doi.org/10.1186/s13052-017-0396-2
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author Porcaro, Federica
Valfré, Laura
Aufiero, Lelia Rotondi
Dall’Oglio, Luigi
De Angelis, Paola
Villani, Alberto
Bagolan, Pietro
Bottero, Sergio
Cutrera, Renato
author_facet Porcaro, Federica
Valfré, Laura
Aufiero, Lelia Rotondi
Dall’Oglio, Luigi
De Angelis, Paola
Villani, Alberto
Bagolan, Pietro
Bottero, Sergio
Cutrera, Renato
author_sort Porcaro, Federica
collection PubMed
description BACKGROUND: Children with congenital esophageal atresia (EA) and tracheoesophageal fistula (TEF) have chronic respiratory symptoms including recurrent pneumonia, wheezing and persistent cough. The aim of this study is to describe the clinical findings of a large group of children with EA and TEF surgically corrected and the instrumental investigation to which they have undergone in order to better understand the patient’s needs and harmonize the care. METHODS: A retrospective data collection was performed on 105 children with EA and TEF followed at Department of Pediatric Medicine of Bambino Gesù Children’s Hospital (Rome, Italy) between 2010 and 2015. RESULTS: 69/105 (66%) children reported lower respiratory symptoms with a mean age onset of 2.2 ± 2.5 years and only 63/69 (91%) performed specialist assessment at Respiratory Unit. Recurrent pneumonia (33%) and wheezing (31%) were the most reported symptoms. The first respiratory evaluation was performed after surgically correction of gastroesophageal reflux (GER) at mean age of 3.9 ± 4.2 years. Twenty nine patients have undergone to chest CT with contrast enhancement detecting localized atelectasis (41%), residual tracheal diverticulum (34%), bronchiectasis (31%), tracheal vascular compression (21%), tracheomalacia (17%) and esophageal diverticulum (14%). Fifty three patients have undergone to airways endoscopy detecting tracheomalacia (66%), residual tracheal diverticulum (26%), recurrent tracheoesophageal fistula (19%) and vocal cord paralysis (11%). CONCLUSIONS: Our study confirms that respiratory symptoms often complicate EA and TEF; their persistence despite medical and surgical treatment of GER means that other etiological hypothesis must be examined and that a complete respiratory diagnostic work up must be considered.
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spelling pubmed-55840002017-09-06 Respiratory problems in children with esophageal atresia and tracheoesophageal fistula Porcaro, Federica Valfré, Laura Aufiero, Lelia Rotondi Dall’Oglio, Luigi De Angelis, Paola Villani, Alberto Bagolan, Pietro Bottero, Sergio Cutrera, Renato Ital J Pediatr Research BACKGROUND: Children with congenital esophageal atresia (EA) and tracheoesophageal fistula (TEF) have chronic respiratory symptoms including recurrent pneumonia, wheezing and persistent cough. The aim of this study is to describe the clinical findings of a large group of children with EA and TEF surgically corrected and the instrumental investigation to which they have undergone in order to better understand the patient’s needs and harmonize the care. METHODS: A retrospective data collection was performed on 105 children with EA and TEF followed at Department of Pediatric Medicine of Bambino Gesù Children’s Hospital (Rome, Italy) between 2010 and 2015. RESULTS: 69/105 (66%) children reported lower respiratory symptoms with a mean age onset of 2.2 ± 2.5 years and only 63/69 (91%) performed specialist assessment at Respiratory Unit. Recurrent pneumonia (33%) and wheezing (31%) were the most reported symptoms. The first respiratory evaluation was performed after surgically correction of gastroesophageal reflux (GER) at mean age of 3.9 ± 4.2 years. Twenty nine patients have undergone to chest CT with contrast enhancement detecting localized atelectasis (41%), residual tracheal diverticulum (34%), bronchiectasis (31%), tracheal vascular compression (21%), tracheomalacia (17%) and esophageal diverticulum (14%). Fifty three patients have undergone to airways endoscopy detecting tracheomalacia (66%), residual tracheal diverticulum (26%), recurrent tracheoesophageal fistula (19%) and vocal cord paralysis (11%). CONCLUSIONS: Our study confirms that respiratory symptoms often complicate EA and TEF; their persistence despite medical and surgical treatment of GER means that other etiological hypothesis must be examined and that a complete respiratory diagnostic work up must be considered. BioMed Central 2017-09-05 /pmc/articles/PMC5584000/ /pubmed/28870218 http://dx.doi.org/10.1186/s13052-017-0396-2 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Porcaro, Federica
Valfré, Laura
Aufiero, Lelia Rotondi
Dall’Oglio, Luigi
De Angelis, Paola
Villani, Alberto
Bagolan, Pietro
Bottero, Sergio
Cutrera, Renato
Respiratory problems in children with esophageal atresia and tracheoesophageal fistula
title Respiratory problems in children with esophageal atresia and tracheoesophageal fistula
title_full Respiratory problems in children with esophageal atresia and tracheoesophageal fistula
title_fullStr Respiratory problems in children with esophageal atresia and tracheoesophageal fistula
title_full_unstemmed Respiratory problems in children with esophageal atresia and tracheoesophageal fistula
title_short Respiratory problems in children with esophageal atresia and tracheoesophageal fistula
title_sort respiratory problems in children with esophageal atresia and tracheoesophageal fistula
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5584000/
https://www.ncbi.nlm.nih.gov/pubmed/28870218
http://dx.doi.org/10.1186/s13052-017-0396-2
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