Operated esophagus : radiological diagnostics of a 24 year-old man with esophageal atresia associated with congenital tracheo-esophageal fistula : case report

Abstract

Background: Esophageal atresia is a condition, in which the terminal portion of the esophagus is impatent. Esophageal stenosis or narrowing may be congenital or acquired. Atresia is usually (>90% of cases) associated with a tracheo-esophageal fistula, in which there is an abnormal continuity between the trachea and the esophagus. The prevalence of esophageal atresia at birth has been estimated at about 1 per 2500 or 1 per 3500 worldwide. We report the case of a 24-year-old man with abdominal pains and anemia. The condition of the man with esophageal atresia after 4 operations was associated with a congenital tracheo-esophageal fistula. The study includes images and conclusions from barium radiography of the upper gastrointestinal tract. Case Report: A 24-year-old man was admitted to hospital. Chest X-ray showed an opacity in the middle and inferior field of the right lung. In the Radiology Department at the Military Medical Institute in Warsaw, the course of the upper part of the alimentary canal was investigated, which revealed the presencve of the following anastomoses: esophago-colonostomy, colono-ileostomy and ileogastrostomy. All the anastomoses were tight and patent. Contrast retention in the extension of colon haustrum was visible. The anastomosed part of the small bowel was considerably distended and presented reflux to a part of the colon. There was an ulcer in the gastric body.The an opacity in the middle and inferior field of the right lung was caused by a colon segment and primarily by the distended part of the small intestine. Conclusions: The diagnostics of operated esophagus is difficult. A review radiography of the upper gastrointestinal tract segment should be performed, which enables to visualize morphological and functional abnormalities at a relatively low x-ray dose and at low cost. It is considered to be the most sensitive and accurate diagnostic tool