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• W2170385407 abstract "An 11-year-old male patient with a history of developmental delay, deafness, reactive airway disease, chronic gastroesophageal reflux disease, subglottic stenosis, Nissen fundoplication, and gastrostomy placement in infancy had his gastrostomy removed at age 10 and presented to our outpatient office 2 months later complaining of persistent leakage from the gastrocutaneous fistula. There was no coughing, gagging, or choking with oral feeds. He underwent an esophagogastroduodenoscopy to close the fistula via clipping, and an incidental finding of an irregular patch of nodular mucosa was visualized in the mid-esophagus. Figure A demonstrates the lesion under endoscopy and delineates it also through the use of narrow band imaging. Biopsies revealed 2 types of mucosa, squamous epithelium as well as columnar (Figure B). Under higher magnification, ciliated columnar (respiratory-type) mucosa with chronic inflammation can be appreciated (Figure C). He was diagnosed with incidental finding of ectopic tracheobronchial remnant. Previous esophageal imaging and bronchoscopy failed to demonstrate any fistulous tract. Tracheobronchial remnants might be of the tracheobronchial type, containing respiratory epithelium, bronchial glands, cartilage, and lymphatic tissue in the submucosa or muscularis propria, and occur in the abdominal portion of the esophagus. During embryogenesis, esophageal and respiratory mucosae are both simple columnar. Cilia appear by the 10th week of gestation, and by the fourth month, the squamous epithelium of the esophageal mucosa becomes appreciable.1Takubo K. Pathology of the esophagus: an atlas and textbook. Springer Science and Business Media, Hong Kong2009Crossref Scopus (17) Google Scholar In our case, the patient also had congenital subglottic stenosis, an anomaly thought to occur during the third month of gestation as a result of an incomplete recanalization of the laryngotracheal tube. This suggests that there might be an overlap in the timing of the development of these congenital defects or possibly an antenatal insult. Tracheobronchial remnants have been diagnosed in association with esophageal stenosis and tracheoesophageal fistulas. Case reports in the literature refer to congenital esophageal stenosis attributed to tracheobronchial remnants that often present with symptoms of dysphagia or vomiting.2Zhao L. Hsieh W.S. Hsu W.M. Congenital esophageal stenosis owing to ectopic tracheobronchial remnants.J Pediatr Surg. 2004; 39: 1183-1187Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar When associated with congenital esophageal stenosis, management might be through balloon dilatation, but surgical resection might be necessary.3Vasudevan S.A. Kerendi F. Lee H. et al.Management of congenital esophageal stenosis.J Pediatr Surg. 2002; 37: 1024-1026Abstract Full Text Full Text PDF PubMed Scopus (56) Google Scholar An index of suspicion should be maintained when investigating a child with dysphagia. However, the incidental ectopic mucosa might not require any additional intervention." @default.
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• W2170385407 date "2011-05-01" @default.
• W2170385407 modified "2023-10-14" @default.
• W2170385407 title "Tracheobronchial Remnants: A Rare Congenital Anomaly" @default.
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• W2170385407 doi "https://doi.org/10.1016/j.cgh.2010.12.016" @default.
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