Name: Tracheosofaginės Fistulės ir Stemplės Atrezijos 3D Modelis Erler-Zimmer Tracheoesophageal Fistula and Oesophagus Atresia 3D Printed Model - Labostera
SKU: MP2059
Availability: BackOrder

„Erler-Zimmer GmbH & Co. KG 3D model of tracheoesophageal fistula and esophageal atresia:

Model Number: MP2059
Clinical history:
A 32-year-old woman, G3P0 (3rd pregnancy, 0 births), went into premature labor at 25 weeks' gestation. The physician noted an increase in fundal height of 30 cm a week earlier, but the woman declined prenatal testing or ultrasound and was not followed up. She delivered a live male child. Examination of the infant revealed multiple digits, an imperforate anus, excessive salivation, and a loud pansystolic nasal murmur. A single splenic artery was noted in the umbilical cord. The infant had difficulty feeding due to increasing respiratory failure. The infant died 2 days later of aspirated pneumonia.
Pathology/Specimen details:
The specimen includes the fetal tongue, larynx, trachea, bronchi, both lungs, and esophagus. The trachea and bronchi are divided in the middle. The fistula is located just above the lobes of the communicating fistula connecting the distal esophagus to the trachea (arrow). This is an example of a type C tracheoesophageal fistula (esophageal atresia with distal tracheoesophageal fistula). It is difficult to determine whether the esophagus ends as a blind pouch below the margin of the specimen.
Additional information:
Tracheoesophageal fistula (TEF) is a common congenital anomaly, occurring in approximately 1 in 4000 live births. TEF usually occurs in association with esophageal atresia. TEFs are classified according to their anatomical configuration. Type C configuration is the most common; as described above, distal tracheoesophageal fistula accounts for 86% of TP3T cases. TEF occurs without esophageal atresia in only 41% of TP3T cases, type E.
TEF and esophageal atresia are caused by defects in the longitudinal lobule at the junction of the esophagus and trachea. The defect is thought to result in a failure of the pulmonary bud branches during epithelial-mesenchymal interactions to branch into a fistula tract. This is associated with VACTERL (spinal defects, anal atresia, cardiac defects, TEF, renal anomalies, and limb anomalies) or CHARGE syndrome (coloboma, cardiac defects, choanal atresia, growth retardation, genital anomalies, and ear anomalies). Esophageal atresia can be seen on prenatal ultrasound as polyhydramnios, an absent/collapsed stomach, and a dilated esophageal pouch. EA with TEF may be more difficult to see on ultrasound because the fistula allows fluid to leak into the stomach. Polyhydramnios occurs in one-third of cases of EA with distal TEF. Postpartum symptoms vary depending on the configuration of the fistula. These include excessive salivation, respiratory failure, feeding difficulties, and cleft palate. Reflux of stomach contents can cause aspiration pneumonia, as in this case.
Diagnosis can be made by failure of a nasogastric tube to enter the stomach along with X-rays. Fluoroscopy with contrast may be used for more complex cases. In milder cases, the diagnosis may be made later by endoscopic examination. Treatment involves surgical correction of the defects. The prognosis is usually good. However, in cases with associated chromosomal, primary birth, and cardiac defects, the risk of death is increased.