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KMID : 0812020010070010021
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Korean Journal of Neurogastroenterology and Motility
2001 Volume.7 No. 1 p.21 ~ p.28
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Motor Dysfunction of the Esophagus after Repair of Esophageal Atresia and Tracheoesophageal Fistula
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Kim Jae-Young
Choe Byung-Ho
Ko Jae-Sung
Park Kwi-Won
Seo Jeong-Kee
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Abstract
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Background/Aims: The aim of this study was to characterize the spectrum of esophageal motor dysfunction after
repair of an esophageal atresia with a tracheoesophageal fistula (EATEF).
Methods: This study included 16 patients, aged 0.8 to 13.3 years, who were diagnosed with Gross Type C esophageal atresia and underwent a fistula repair and end to end anastomosis. Esophageal function was evaluated with manometry, 24 hour esophageal pH monitoring, a barium esophagogram, and an endoscopy.
Results: Symptoms were present in 8 patients (dysphagia for solid food in 2; frequent vomiting in 6; and poor weight gain in 4). Anastomotic stricture was present in 6 patients. An esophageal manometric study showed that the reflex relaxation of the lower esophageal sphincter (LES) was incomplete or absent in 9 patients (56%). The upper esophageal sphincter (UES) was completely relaxed in all 16 patients. In 14 patients (88%), a normal peristaltic wave was present in the proximal esophagus, but absent below the anastomotic site. Simultaneous contractions were observed in 2 patients (12%). Seven (64%) of 11 patients who underwent 24 hour esophageal pH monitoring presented gastroesophageal reflux.
Conclusion: Most of the patients after the repair of an EATEF developed motor dysfunction of the esophagus. Poor transmission of the peristaltic waves beyond the anastomotic site and abnormal reflex relaxation of the LES were present.(Korean Journal of Gastrointestinal Motility 2001;7:21-28)
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KEYWORD
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Esophageal atresia, Tracheoesophageal fistul, Esophageal manometry, Esophageal motor dysfunction
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