Low flow intermittent bronchoscopic oxygen insufflation to identify occult tracheo-esophageal fistulas.
Respir Med
; 186: 106544, 2021 09.
Article
em En
| MEDLINE
| ID: mdl-34325240
ABSTRACT
BACKGROUND:
Esophageal atresia and tracheo-esophageal fistula (TEF), a well described congenital anomaly of the aero-digestive tract, commonly presents with inability to swallow and feed immediately after birth. However, diagnosis of recurrent or isolated TEF can be challenging and requires a combination of endoscopic and contrast studies. We describe a hitherto unreported technique of low flow intermittent oxygen insufflation into the suspicious tract and examine its safety and diagnostic yield for identification of occult TEF.METHODS:
A retrospective single center cohort study, analyzing case notes of patients with TEF who underwent bronchoscopic oxygen insufflation for suspected recurrent or isolated TEF between 2006 and 2019 at a tertiary pediatric hospital.RESULTS:
One-hundred and seven patients with TEF underwent 142 bronchoscopies during the study period. Of these, 22 patients underwent 28 bronchoscopies with oxygen insufflation. Twelve (43%) open fistulas were identified; of these, 9 (75%) were found using oxygen insufflation, revealing the fistula in 4/9 (44%) cases that had not been apparent using simple bronchoscopic visualization alone. One fistula was missed with multiple investigations, including bronchography and found only using oxygen insufflation. No complications were encountered.CONCLUSIONS:
Recurrent or isolated TEF may be missed using ordinary flexible bronchoscopy and imaging studies. Low flow oxygen insufflation can be applied safely and may detect otherwise occult TEF.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Oxigênio
/
Broncoscopia
/
Insuflação
/
Fístula Traqueoesofágica
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Child
/
Female
/
Humans
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Male
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article