気管原基迷入型食道狭窄症を合併した Gross A型食道閉鎖症の2治験例

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  • Two Cases of Congenital Esophageal Atresia of Gross A Type Associated with Congenital Stenosis of the Distal Esophagus due to Tracheobronchial Remnants
  • キカン ゲンキ メイニュウガタ ショクドウ キョウサクショウ オ ガッペイシタ

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Congenital esophageal atresia with congenital stenosis in the distal esophagus has been rarely reported. Two cases with congenital esophageal atresia of Gross A type with congenital esophageal stenosis due to tracheobronchial remnant are reported in this paper. Case 1: A female newborn with congenital esophageal atresia of Gross A type, underwent a gastrostomy. X-ray examination suspected stenosis in the lower esophagus. At esophageal reconstruction with a colon segment at the age of 9 months, an induration of the esophageal wall 2 cm oral from esophagogastric junction was found. Histologic examination of the lower esophageal segment revealed trancheobronchial remnant. Case 2: A 5-day-old female newborn underwent a gastrostomy for congenital esophageal atresia of Gross A type. An X-ray examination revealed lower esophageal stenosis. At the age of 9 months, esophageal reconstruction was performed similarly as in Case 1. Histologic examination of the lower esophageal segment showed the mucous glands and pseudocolumnar ciliated epithelium. Eight cases of congenital esophageal atresia with congenital esophageal stenosis due to tracheobronchial remnant were reviewed from literature, including one reported previously from our Hospital. Among 10 cases including two of our present study, 6 underwent esophageal reconstruction. X-ray examination of lower esophagus prior to radical operation and sham feeding as preoperative management seem to be important in the patient with congenita esophageal atresia of Gross A type with congenital esophageal stenosis.

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