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Pediatric Chest Imaging - part 6

Sơ đồ dòng thể hiện mối quan hệ giữa thực quản và khí quản ở trẻ em bình thường và trong các hình thức khác nhau của hẹp thực quản và lỗ rò khí thực quản. Các loại được rút ra để giảm tần số. Ghi nhớ thấp Noh đôi cao phản ánh thứ tự của tần số của các loại dị tật hẹp thực quản và khí thực quản. | 286 FORDHAM Fig. 2. Line diagram showing the relationship between the esophagus and trachea in normal children and in different forms of esophageal atresia and tracheoesophageal fistula. The types are drawn in order of decreasing frequency. The mnemonic low-noH-double-high reflects the order of frequency of the various types of esophageal atresia and tracheoesophageal malformations. ageal 1 and EA with a proximal TEF 1 segment and other very rare variations 29 30 . At birth babies with a connection between their distal esophagus and their airway have air in the gastrointestinal tract. Those with pure EA or an EA with a proximal TEF have a gasless abdomen. Fifty to 70 of children with EA have associated congenital anomalies involving the cardiovascular 35 genitourinary 20 gastrointestinal 24 neurologic 10 and skeletal 13 systems 31-37 . The VACTERL Vertebral anomalies Anal atresia-malformation Cardiac anomalies Tracheal to Esophageal fistula Renal and Limb-including ra dial ray-anomalies association is seen in 25 of these patients 31 - 37 . In children the diagnosis of EA with possible TEF is made on the basis of clinical grounds. There may also be a history of polyhydramnios. The patient is either unable to tolerate their own secretions with drooling and respiratory distress or the child may present with coughing and choking spells limited to initiation of feeding. The clinical suspicion is confirmed by failure to pass an enteric tube into the stomach. If the diagnosis is in question air can be instilled by the enteric tube to distend the proximal esophagus and demonstrate the dilated proximal ELSEVIER SAUNDERS Radiol Clin N Am 43 2005 325 - 353 RADIOLOGIC CLINICS of North America Imaging Evaluation of Pediatric Mediastinal Masses Arie Franco MD PhDa Neeta S. Mody MDb Manuel P. Meza MDa Department of Radiology Children s Hospital of Pittsburgh Pittsburgh PA 15213 USA Department of Radiology Western Pennsylvania Hospital Pittsburgh PA 15224 USA The mediastinum is .