Trachea diseases and esophagus diseases The Otolaryngology Faculty of Shanghai Jiao Tong University School of Medicine Xiang Mingliang
Anatomy of trachea and bronchus
Trachea: in the middle of neck and thoracic cavity trachea rings in total, and 7- 8 ring in the neck.
Bronchus tree. The angle between the trachea and the bronchus: left45 o, right25 o
carina of trachea: the end of trachea. A important mark in the bronchoscopy
Anatomy of esophagus
Muscular organ. Pipe in shape Inner layer: mucosa Middle layer: submucosal tissue external layer: muscle
Physiological stenosis in esophagus 1 ) from upper incisor 16cm 2 ) from upper incisor 23cm 3 ) from upper incisor 27cm 4 ) 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 atelectasis CT scan : three-dimensional rebuild treatment : bronchoscopy
Foreign body in bronchus
Foreign body in trachea
Foreign body in bronchus
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
Location of foreign body The first stenosis: most seen The second stenosis The third stenosis
Clinic symptoms dysphagia odynophagia dyspnea : large foreign body
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 , d ysphagia,odynophagia , disorder sign in X- ray treatment : esophagoscopy Electronic gastroscopy open : foreign body in out of esophagus, injury of large artery
Foreign body in esophagus
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