There are four types of doubling: cystic, diverticular, tubular and segmental-intramural. The common property of all duplicates is their close contact with the esophagus and the lack of communication with it.
Cystic duplications differ in size, level of disposition of the mediastinum and the presence of the mucosa on the inner wall. The form is ill-circular, the diameter varies from 5 to 10 cm. Localized mainly upward and middle third of the esophagus.
The growth of cystic duplications toward the right pleural cavity occurs 2.5 times more often than in the left. The communication between the cavity of duplication and the enlightenment of the esophagus or bronchus is very rare and occurs in the process of doubling growth as a complication of this malformation. The mucous membrane that lining the inner surface of the duplication is identical in structure to the lining of the stomach (45.4%) or the esophagus (35.7%).
Clinical symptoms
The main clinical manifestations are already noted in the first half-year of the child's life. They are caused mainly by a violation of patency, compression of the trachea and esophagus. Approximately half of the children have symptoms associated with the processes occurring in the cyst itself, for example, the stretching of the capsule causes pain sensations, the accumulation of the contents and absorption by its mucous membrane leads to the appearance of fever. In some cases, bleeding occurs. Occasionally, the cystic doubling of the esophagus flows asymptomatically and is detected accidentally by a prophylactic X-ray examination.
Despite the closer adherence of the cysts to the wall of the esophagus, clinical manifestations of compression of the trachea and bronchi are observed earlier, which is probably connected with a greater displacement of the esophagus. Symptoms of compression are coughing, a feeling of sadness in breathing. In the future, develop respiratory disorders, expressed in the form of a stridor, a partial obstruction of the respiratory tract. Last, in the end, leads to the development of acute or chronic pneumonia, atelectasis and bronchiectasis.
The later symptoms of compression of the esophagus are manifested in vytesrygivaniya, vomiting and dysphagia. These symptoms are of a permanent nature, while at the same time as breathing disorders occur as seizures. Regurgitation and vomiting immediately after swallowing. In vomit and regurgitated mass contains unchanged food.
Bleeding can be a consequence of a complication of cystic doubling-breaking of the cyst into the esophagus or the respiratory tract. In these cases, the blood admixture is found in the sputum or regurgitated food gruel. When the bleeding cavity cysts it is hidden (occult).
Cystic duplications are combined with the developmental defects of other organs, in particular with the anomalies in the development of vertebrae and ribs.
Since there are no characteristic clinical symptoms of cystic doubling of the esophagus, an X-ray method is used to diagnose it. With the help of this method, cystic doubling of the esophagus reveals rounded formations in the posterior mediastinum, often combined with congenital deformation of the vertebrae and ribs. However, rounded formation must be differentiated from non-neurogenic tumors, bronchogenic and dermoid cysts, and abscesses. X-ray contrast examination, as well as the previous one, does not allow to establish an accurate diagnosis of cystic doubling of the esophagus, since the signs of compression and displacement of the esophagus testify to the presence of volumetric education, but not its nature.
Not sufficiently informative is the endoscopic examination of the esophagus and bronchial tree.
Puncture cyst seems to be a rather dangerous procedure, since, without changing anything in relation to medical practice, it creates the danger of infecting the mild mediastinum tanni.
Treatment
The only method of treatment of cystic doubling of the esophagus is operative (removal of the cyst). The results of surgical treatment are quite satisfactory.
As for the other types of esophagus doubling, they are extremely rare and of no practical importance.
Grow healthy!