trachea diseases and esophagus diseases the otolaryngology faculty of shanghai jiao tong university...
TRANSCRIPT
Trachea diseases and esophagus diseases
The Otolaryngology Faculty of Shanghai Jiao Tong University School
of Medicine
Xiang Mingliang
Trachea: in the middle of neck and thoracic cavity. 16-20 trachea rings in total, and 7-8 ring in the neck.
Muscular organ. Pipe in shapeInner layer: mucosaMiddle layer: submucosal tissue external layer: muscle
Physiological stenosis in esophagus
1 ) from upper incisor 16cm2 ) from upper incisor 23cm3 ) from upper incisor 27cm4 ) from upper incisor 36cm
foreign body in trachea and bronchus
Source: external、 internal
Classification of foreign body: plant: peanut、 seeds.
animal: fishbone、 bone pieces
mineral: iron nail
synthetic product: dental
prosthesis
90% cases﹤5 years, 80% cases ﹤ 3 years
causes: 1 ) poorly chew function,
poorly pharyngeal reflex
2 ) unconscious, aspiration
3) unhealthy habit: foreign body
in mouth
4 ) medical:
Factors associated with clinic presentation• foreign body sorts : peanut , chemical
bronchitis• Size:• Shape:• Stay time:• Stay site• Infection or not:
• presentation– Inhaled period: cough, dyspnea
– Quiet period: no any symptom
– Infection period: cough, dyspnea, fever
– Complication period: atelectasis、emphysema、 lung infection
diagnosis: history of foreign
body, dyspnea、 cough, disorder
sign in X-ray
X-ray: 1 ) obstructive emphysema
2 ) obstructive atelectasisCT scan: three-dimensional rebuild
treatment: bronchoscopy
Foreign body in esophagus
cause
• More cases in old: poorly chew function,
disesthesia of mouth, dental prosthesis
• More cases in children : like to put toy
in his mouth
• Eating too quick
• Stenosis or lump in esophagus
• suicide
Sorts of foreign body • animal : fishbone,bone pieces, meat lump
• metals : coin• synthetic product : dental prosthesis
• plant : kernel
X-ray examination
nonopaque: positive in barium x-ray
study
opaque: x-ray flat. entopic and
lateral examination of esophagus
complication
• Esophagus perforation
• Infection of periesophagus organ :neck,mediastinum
• Large artery disruption
• Tracheal-esophageal fistula
diagnosis: history of foreign
body, dysphagia,odynophagia , diso
rder sign in X-ray
treatment:• esophagoscopy• Electronic gastroscopy• open: foreign body in out of esophagus,
injury of large artery