19.8 Pathology



Pathology of the foregut


In the lower foregut region fistulas, stenosis and ectopic tissue also form the main class of the abnormalities.



Abnormalities in the esophagus region


The most frequent disorders such as fistulas or atresias of the esophagus are associated with abnormalities of the developing respiratory tract. Fig. 45 - Abnormalities of the
esophagus
 Legenda

A

B
C


D


1
2
Atresia of the esophagus with a
beginning fistula
Atresia of the esophagus
Atresia of the esophagus with
fistula of the lower esophagus -
a section to the trachea
Atresia of the esophagus with
fistula of the upper esophagus-
a section to the trachea
Trachea
Esophagus

Fig. 45
There are many variations of abnormal relationships between the trachea (1) and esophagus (2).



Other, more seldom abnormalities such as stenosis of the esophagus result from a missing recanalization during development. Both with atresias and with stenosis of the esophagus the fetus cannot swallow and thus reabsorb amniotic fluid, a situation leading to a polyhydramnion.



Pyloric stenosis


The pyloric stenosis arises through a hyperplasia of the pyloric sphincter muscle and is a relatively frequent disorder, mainly in male newborns. It leads to sudden and convulsive vomiting and can be rectified by a longitudinal incision of the pyloric sphincter muscle.



Duodenal stenosis


Stenosis as well as atresias can also occur in the small intestine. As in the esophagus they are based on an absent recanalization of the lumen. Such disorders are nevertheless very seldom.



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