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. 16-20 trachea rings in total, and 7-8 ring in the neck.

Bronchus tree. The angle between the trachea and the bronchus:

left45o,right25o

carina of trachea: the end of trachea. A important mark in

the bronchoscopy

Anatomy of esophagus

Muscular organ. Pipe in shapeInner layer: mucosaMiddle layer: submucosal tissue external layer: muscle

Physiological stenosis in esophagus

1 ） from upper incisor 16cm2 ） from upper incisor 23cm3 ） from upper incisor 27cm4 ） 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 atelectasisＣＴ scan： three-dimensional rebuild

treatment： bronchoscopy

Foreign body in bronchus

Foreign body in bronchus

Foreign body in trachea

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， dysphagia,odynophagia ， diso

rder sign in X-ray

treatment：• esophagoscopy• Electronic gastroscopy• open： foreign body in out of esophagus,

injury of large artery

Foreign body in esophagus

Foreign body in esophagus

Thanks