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Esophageal atresia

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Contents of this page:

Illustrations

Tracheoesophageal fistula repair - series
Tracheoesophageal fistula repair - series
Esophagus and stomach anatomy
Esophagus and stomach anatomy

Alternative names    Return to top

Tracheoesophageal fistula

Definition    Return to top

Esophageal atresia is a disorder of the digestive system in which the esophagus does not develop properly. The disorder is a congenital defect, which means it occurs before birth. There are several types.

Causes, incidence, and risk factors    Return to top

The esophagus is the tube that normally carries food from the mouth to the stomach. In most cases of esophageal atresia, the upper esophagus ends blindly and does not connect with the lower esophagus and stomach. In these cases, the top end of the lower esophagus is connected with the trachea (windpipe). This connection between the lower esophagus and the trachea is called a tracheoesophageal fistula (often abbreviated TEF).

Over 30% of people affected by this condition will also have other abnormalities, such as heart disorders or other gastrointestinal tract disorders. Other types of esophageal atresia involve narrowing of the esophagus and may also be associated with other birth defects.

This condition is frequently complicated by the infant's breathing saliva and secretions into the lungs, causing pneumonia, choking, and possibly death. It is considered a surgical emergency.

The disorder is usually detected shortly after birth when feeding is attempted and the infant coughs, chokes, and turns blue (cyanosis). Immediate surgical repair of this disorder is required so that the lungs are not damaged and the baby can be fed.

Symptoms    Return to top

Signs and tests    Return to top

Prior to birth, the presence of excessive amniotic fluid will arouse suspicion of esophageal atresia or other obstruction of the gastrointestinal tract.

After birth, as soon as the diagnosis is suspected, an attempt to pass a small feeding tube (nasogastric tube) through the mouth or nose into the stomach should be made. The feeding tube will not be able to pass all the way to the stomach in a baby with esophageal atresia.

An X-ray of the esophagus shows an air-filled pouch and air in the stomach and intestine. If a feeding tube was passed it will be seen coiled up in the upper esophagus.

Treatment    Return to top

Surgery to repair the esophagus is done quickly after the infant has been stabilized. Before the surgery, the infant is not fed by mouth, and care is taken to prevent the infant from breathing secretions into the lungs.

Expectations (prognosis)    Return to top

An early diagnosis gives a better chance of a good outcome.

Complications    Return to top

Calling your health care provider    Return to top

This disorder is usually diagnosed shortly after the birth of an infant.

Call your infant's health care provider if the infant regurgitates repeatedly after feedings, or if the infant develops breathing difficulties.

Update Date: 1/12/2003

Updated by: Andrew J. Muir, M.D., M.H.S., Division of Gastroenterology, Duke University Medical Center, Durham, NC. Review provided by VeriMed Healthcare Network.

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