Esophageal and Pulmonary Conditions
At Mount Sinai, our expert pediatric surgeons diagnose and treat a wide range of thoracic and pulmonary conditions. Some of these conditions appear at birth while others happen during childhood or adolescence. We use minimally invasive (thoracoscopic) techniques whenever possible. Depending on the individual situation and your child’s overall health, an open incision (thoracotomy) may be most appropriate.
About Esophageal and Pulmonary Conditions
Thoracic conditions we see most often include:
- Esophageal atresia with or without tracheoesophageal fistula (TEF) happens when your child’s esophagus doesn’t develop properly and has a gap or an improper passageway (fistula). A child with EA-TEF might have trouble swallowing, causing serious and sometimes fatal conditions. We treat this condition quickly, often within the first few days of life.
- Esophageal duplication cysts can develop anywhere along the upper gastrointestinal tract. The condition can make it difficult for your child to swallow, or breath, but may be asymptomatic.
- Esophageal stenosis is when a child has an extremely narrow esophagus (food tube) that makes it hard to swallow. It can be present at birth (called congenital) or can develop over time.
Pulmonary conditions that we regularly diagnose and treat include:
- Bronchopulmonary sequestration results when a part of the lung develops outside of the main body of the lung. This abnormal part of the lung does not function properly and receives its blood from the systemic circulation (the aorta) instead of the blood vessels within the lung. If untreated, this condition can lead to heart failure.
- Collapsed lung (pneumothorax) is when air gets between one of your child’s lungs and the wall of the chest, pressing down on the lung. This can make it hard for your child’s lungs to expand and get oxygenated blood back to the heart.
- Congenital pulmonary airway malformation (CPAM) can result from abnormal lung development. It can cause parts of the lung to appear solid (cystic), which can increase your child’s risk of pneumonia and other infections and can also increase risk of developing cancer.
- Pleural effusion/hemothorax, or development of fluid (effusion) or blood (hemothorax) in the chest space outside of the lung, can make it difficult for your child to breathe.
- Pleural empyema is when pus collects in your child’s chest, just outside the lungs, making it hard to breathe.
Diagnosis and Treatment
To diagnose esophageal and pulmonary conditions, we often start by ruling out other conditions. If it appears that you do have an esophageal or pulmonary condition, we may perform an endoscopy, a nonsurgical procedure that enables us to see what is happening in your child’s swallowing tube (esophagus), stomach, and the top part of the bowel (duodenum). To do this, we insert a long flexible tube (endoscope) with a camera on the end down the throat to the duodenum.
Treatments for esophageal and pulmonary conditions vary, based on the specific diagnosis and your child’s individual health. In general, we use minimally invasive or open surgical procedures to remove the problem, be it a cyst, pus, or extra air. Some conditions have a specific approach, such as repair of esophageal atresia.