Title ATREZIJA JEDNJAKA
Title (english) ESOPHAGEAL ATRESIA
Author Nika Brajenić
Mentor Harry Nikolić (mentor)
Committee member Nado Bukvić (predsjednik povjerenstva)
Committee member Tedi Cicvarić (član povjerenstva)
Committee member Srećko Severinski (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Surgery) Rijeka
Defense date and country 2019-07-12, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Pediatrics
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Surgery
Abstract Atrezija jednjaka prirođena je anomalija koja podrazumijeva nepostojanje lumena jednjaka i često je povezana s traheoezofagealnom fistulom. Pojavnost joj je 1 na 3000 živorođene djece. Etiologija nije u potpunosti razjašnjena, međutim pretpostavlja se da je posljedica poremećaja razvitka jednjaka od 4. do 6. embrionalnog tjedna. Razlikuje se 6 tipova atrezije, a najčešća je atrezija jednjaka s distalnom traheoezofagealnom fistulom. Sumnja se postavlja ultrazvučnim pregledom fetusa – nalazom polihidramniona ili hipoplazije želuca. Nakon rođenja javlja se hipersalivacija te gušenje, kašalj i regurgitacija prilikom hranjenja, a kod postojanja fistule česte su pneumonije. Dijagnoza se postavlja na temelju simptoma te potvrđuje sondiranjem jednjaka i rendgenskom dijagnostikom. Nužan je hitni operativni postupak, a cilj je zatvoriti traheoezofagealnu fistulu te uspostaviti kontinuitet probavne cijevi. Ukoliko je razmak između bataljaka kratak, uspostavlja se teleskopska termino – terminalna anastomoza. Kod dugog razmaka između bataljaka nastoji se približiti bataljke ili nadomijestiti jednjak segmentom crijeva, gastričnim režnjem ili gastričnim tubulusom. Rizik je veći u djece male porođajne težine, s asocijativnom malformacijom i respiratornom bolešću te se u njih preporuča odgođeni i etapni operativni zahvat. Moguće su postoperativne rane i kasne komplikacije. Prognoza uvelike ovisi o stanju djeteta, ali i o preoperativnoj njezi, odabiru najpogodnijeg operativnog zahvata te postoperativnim komplikacijama.
Abstract (english) Esophageal atresia is a congenital anomaly that is considered as the absence of esophageal lumen, often associated with tracheo-esophageal fistula. It appears in about 1 out of 3,000 live-born children. Etiology is not fully clarified, but it is presumed to be a consequence of the developmental disorders of the esophagus from the 4th to 6th embryonic week. There are 6 types of atresia, and the most common is esophageal atresia with distal tracheo-esophageal fistula. The suspicion is based on ultrasound examination of the fetus - a finding of polyhydramniosis or hypoplasia of the stomach. After birth there is hypersalination and choking, coughing and regurgitation during feeding, and in the presence of fistula there are frequent pneumonia. The diagnosis is based on the symptoms and is confirmed by the stifling the catheter in the esophageal pouch and by the X-ray diagnostics. An urgent surgical procedure is needed, and the aim is to close the trachea-esophageal fistula and to establish the continuity of the digestive tract. If the distance between the upper and lower pouch is short, the immediate primary anastomosis is established. In cases of the long gap between the upper and lower pouch, it is necessary to bridge the gap between pouches or to reconstruct the esophagus using an intestinal segment, the gastric lobe or the gastric tube. The risk is higher in children with low birth weight, with associative malformation and respiratory disease, and delayed and staged repair is recommended. Postoperative early and late complications are possible. The prognosis depends on the condition of the child and also on preoperative care, selecting the most appropriate surgical procedure and the postoperative complications.
Keywords
atrezija jednjaka
traheoezofagealna fistula
rekonstrukcija jednjaka
Keywords (english)
esophageal atresia
tracheo-oesophageal fistula
esophageal reconstruction
Language croatian
URN:NBN urn:nbn:hr:184:312491
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Repository Repository of the University of Rijeka, Faculty of Medicine
Created on 2019-12-18 08:43:47