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congenital anomalies can happen in
utero
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5 different anomalies that can happen depending on where the fistula is location
- tracheo-esophageal anomalies
- choanal atresia
- pierre-robin syndrome aka retrognathia
- congenital diaphragmatic hernia
- necrotizing enterocolitis (NEC)
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the esophagus is trunkated- a dead end
esophageal atresia
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a fistula that occurs btwn the trachea and the esophagus
tracheo-esophageal fistula
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is the dead end, a closure or an absence (should be a tube)
atresia
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opening, a communication btwn the trachea and the esophagus (comm. btwn 2 structures)
fistula
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clinical sign and symp of tracheo-esophageal anomalies
- inability to swallow food or saliva
- (if an atresia of the esophagus has a dead end on it, it will eventually fill up w/ food, liquids, saliva and eventually will not be able to swallow)
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the first symptom you will see in tracheo-esophageal is *
excessive drooling
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main diagnosis of tracheo-esophageal *
feeding tube/ NG tube is attempted to pass, it will not be able to passed bc of the atresia
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treatment for tracheo-esophageal
- keep neonate elevated 30' will help with the aspiration and drooling
- surgical repair
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2. choanal atresia has to deal with the
nose
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choanal atresia occurs when a
membrane in the nasal cavity fails to disenagrate. it should disenagrate on its own
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see signs of distress, may see retractions, cyanotic.
unilateral
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how to diagnose choanal atresia
inability to pass a NG tube or feeding tube or catheter.
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tx of choanal atresia
- immediate insertion of an oral airway
- have membrane surgically removed.
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3 pierre robin syndrome is also known as
retrognathia
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pierre robin syndrome has to do w/ the
- mandible/chin
- (underdevelopement of the jaw or hypoplasia, makes it look like they have a big tongue which blocks the airway)
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clinical signs and symptoms of pierre robin
- resp distress
- choke on their feedings
- chronic hypoxia
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diagnosis of pierre robin
visual observation
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treatment of pierre robin
- position them on their bellys (prone)
- -will help tongue to fall forward
- insert nasalpharyngeal airway
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4 congenital diaphragmatic hernia, diaphragm does not
- develop fully of the 2 hemidiaphragms
- failure of the diaphragm to fully develop
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most common diaphragmatic hernia are on the
90% on the left side
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will have a flat, sunken belly called
scaphoid
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diagnosis of congenital diaphragmatic hernia
utero, when an ultrasound is done
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treatment of congenital diaphragmatic hernia
- surgically closed
- oral phragngeal tube down so u can get as much air out of the stomach and intestine as u can
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5 necrotizing enterocolitis NEC
dead bowls, a portion of th ebowel undergo necrosis
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enterocolitis means
inflammation of the colon and small intestine
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NEC is primarly seen in
premature neonates
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NEC causes
- no definitive cause know for why this happens
- related to bacteria or infection
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NEC signs and symptoms
- have abdominal distenstion
- not able to tolerate feedings
- stools will look abnormal - rectal bleeding, bloody stools
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NEC diagnosis
x ray of the abdomen- will see air escaping intho the abdomen if u have death of the bowel tissue.
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NEC treatment
- NG tube asap to decompress as much air as u can
- want to stop feedings
- antibiotics bc of death of the bowel, will have bowel content escaping into the abdomen causing an raging infection.
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