What is atresia, its types, treatment
Atresia is a congenital absence or fusion of holes or channels that are present in a healthy body. This condition can be the result of a number of congenital and acquired causes during life.
What is atresia, its causes
By atresia, experts understand the complete absence of a lumen in the place where it should normally be. The reasons for this process are different:
- alcohol, drug, nicotine addiction in the mother;
- influence of ionizing radiation;
- X-ray examination in the first trimester of pregnancy;
- influence of some poisonous chemicals;
- taking some teratogenic drugs during pregnancy (causing developmental abnormalities);
- late pregnancy (after 35 years);
- hereditary reasons.
Among the causes of acquired forms of atresia, the inflammatory process prevails. Much less often, pathology can occur as a result of a chemical or thermal burn, as well as as a result of hormonal disorders.
Symptoms of various forms of the disease
Depending on which organ is affected, the clinical picture of the disease differs.
Esophageal atresia
A common congenital disease in which a certain area or the entire esophagus is completely absent. Instead, there is a fibrous cord, and the esophagus itself can either end blindly or open into the trachea.
Symptoms of esophageal atresia in a newborn are, firstly, abundant secretion of saliva, which the baby cannot swallow. Secondly, after the first feeding, the child regurgitates all the eaten food. Thirdly, due to the closure of the esophagus, mucus and saliva from the mouth inevitably enters the trachea, resulting in signs of fluid aspiration - wheezing, coughing, shortness of breath, bluish skin and even respiratory arrest.
Repeated episodes of vomiting combined with the actual lack of absorption of food quickly lead to dehydration and death of the baby. Aspiration pneumonia, which inevitably develops on the first day in any newborn with esophageal atresia, can end tragically.
This form of anomaly is often combined with malformations of the heart and trachea. Depending on the severity of the accompanying conditions, the child may die immediately after birth, but may survive if the operation is performed early.
Atresia of the auditory canal
In the congenital form of the disease, atresia is often combined with defects in the development of the auricle, which makes it possible to suspect pathology at the very first examination of a newborn. During an otoscopy, the disease can be detected easily, and an audiogram allows you to detect a decrease in hearing acuity.
In the case of atresia acquired as a result of purulent otitis, burns, and trauma to the temporal bone, deafness gradually develops, which is detected during another examination by an otorhinolaryngologist.
Atresia of the cervical canal
The cervical canal passes through the entire cervix and connects the uterine cavity and the vagina. It is normally closed and opens during menstruation and childbirth. In the postmenopausal period, the cervical canal is not subject to the dilating effect of menstrual blood. In addition, the decrease in the production of sex hormones creates conditions for the thinning of the mucous membrane of the cervix, which is more easily injured and can become sclerotic when it heals. An extreme case of narrowing of the cervical canal is its atresia.
At the congenital form of the pathology, atresia can be detected even in childhood during a dispensary examination. However, it is most often detected only with the onset of menstruation. The girl suddenly has stomach and lower back pains, the temperature rises. During the examination for "acute abdomen" blood accumulation in the uterine cavity or abdominal cavity is revealed, which makes it possible to suspect atresia of the cervical canal. Ultrasound examination usually puts an end to the diagnosis.
Atresia of the anus and rectum
This is one of the most frequent anomalies, it occurs in every five thousandth baby and is often combined with other defects. With retrograde atresia, the diagnosis is made already at the first examination of the baby by a neonatologist. In the absence of a rectum, symptoms appear after about 12 hours. Anxiety arises, the child is anxious, refuses food, the stomach increases, vomiting appears. This is low intestinal obstruction and a threat to the child's life.
Treatment of atresia
Almost any case of atresia requires surgical treatment. A number of operations are performed for esophageal atresia:
- a gastrostomy is applied temporarily when there is a high risk of more extensive interventions;
- esophagoesophagoanastomosis (removal of the closed part of the esophagus and suturing of its two ends);
- plasty of the esophagus with a section of the large intestine, etc.
Atresia of the auditory canal can be treated conservatively by mechanical expansion of the auditory canal. This is possible only with infectious injuries. In other cases, surgery cannot be avoided. First, the possibility of using a hearing aid is determined. If the inner ear is intact, the scars and membranes are removed, and then an artificial auditory canal is created. At the same time, plastic surgery of the auricle is carried out in case of its underdevelopment.
Atresia of the cervical canal in postmenopause does not entail adverse consequences. This is a variant of the norm that does not require correction. When it is detected at the age of puberty, either canal bulging or laser recanalization, or plastic surgery, which prevents the fusion of its walls, is performed.
For atresia of the anus and rectum, the operation is performed in the first hours of life. With a low-lying anomaly, it is possible to perform a one-stage operation that will restore the terminal section of the rectum and the anus. If the narrowed area is too high, then surgeons first install a stoma (artificial anus placed on the front abdominal wall) and later perform plastic surgery of the anus and its connection with the end of the intestine.
In the case of atresia after surgery, analgesics, anti-inflammatory drugs, antibiotics must be prescribed. The patient should be observed by the appropriate specialist. Specialists of the Dobrobut.com clinic recommend following all the specialist's recommendations, and then the consequences of atresia will be minimal.
Related services:
Surgical operations
5.5К view
