Male1: Sometimes, a baby is born and maybe got an early pneumonia or something or bubbling of the mouth and it could be a thing called the TE fistula. What in the world is a TE fistula?
Male2: In the chest, we all have a windpipe, a trachea that brings oxygen to our lungs and allows the carbon dioxide to go out and we have a tube called an esophagus that lets us swallow our milk as babies and eat our dinner. Those structures are formed very early in utero and they can have an abnormal communication between them. And that abnormal communication is called a fistula. That would mean that your breathed air could get to your bowels and your swallowed food could end up in your lungs. Usually, when a baby is born, and it happens in one in three thousand. It is not that rare. Usually! When a baby is born, the tracheoesophageal fistula, they also have a blind ending esophagus. That means that any time they drink, they are going to return their milk, so it is a complicated malformation. The esophagus is ending blindly in the upper chest, so that the baby has a fatal condition. Anything they drink would be returned or sucked into the airway causing death. And, when they breathe, the air can rush into the fistula and swell up the abdomen.
Male1: You as a surgeon, what can you do to help this situation out?
Male2: First aid steps, put an intravenous in the baby, keep the baby warm.
Male1: Stabilize.
Male2: Put the head of the bed up and get a tube over to the tongue to draw out the secretions so they do not go into the lung. The operation is an operation in the chest, it is one of the most defining procedures of pediatric surgery because that is my field involved—the mortality from this disease plummeted and for a baby who does not have a lot of other malformations, if they are not desperately premature, we can have a good long term support to go on to play sports and have children, based on an operation, in which we open the chest and divide that fistula, close the hole in the back of the trachea and reestablish an esophagus so the baby can drink milk and breathe and the two channels can be separated and give him continuity, it is very, very rewarding because that one with a fatal condition with the right first aid, transfer to the children’s hospital with good pediatric anesthesia, a team including a neonatologist, a good pediatric surgeon, you can have a wonderful long term result.
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