Esophageal Atresia - treatment, repair and surgery

Esophageal Atresia - treatment, repair and surgery

Esophageal Atresia is a CONGENITAL ANOMALY in which the ESOPHAGUS fails to form properly and does not connect to the STOMACH. The esophagus may stop short at any location from the back of the THROAT to the top of the stomach or may extend to the stomach but not connect. Often there is also a tracheal–esophageal fistula (opening between the TRACHEA and the esophagus) that allows excessive air to enter the stomach and can permit saliva as well as gastric secretions to enter the LUNGS. These anomalies require emergency intervention. The risk of ASPIRATION is especially serious, as fluids in the lungs can quickly lead to INFECTION and PNEUMONIA.

Esophageal Atresia Treatment and Surgery

Treatment requires surgery, the nature and timing of which depend on where the esophagus ends. The doctor may surgically insert a feeding tube into the stomach to instill breast milk or formula for feeding, as well as a nasogastric tube into the portion of esophagus extending from the throat to suction saliva. Because the esophagus elongates as the child grows, doctors sometimes delay complete surgical reconstruction for 6 to 18 months. The feeding and suction tubes remain in place until the surgery, sometimes a series of operations over several months, is complete.

The esophagus forms very early in PREGNANCY, at about 30 gestational days. Nearly always esophageal atresia and any related anomalies show up on prenatal ULTRASOUND so both doctors and parents can make treatment decisions before the infant’s birth. Esophageal atresia tends to occur as one of numerous congenital anomalies that may involve the spine, HEART, other parts of the gastrointestinal system, the kidneys, and the extremities, a constellation doctors refer to as VACTERL. Doctors often use MAGNETIC RESONANCE IMAGING (MRI) or COMPUTED TOMOGRAPHY (CT) SCAN to thoroughly examine the infant for these anomalies.

See also ANAL ATRESIA; BIRTH DEFECTS; BOWEL ATRESIA; CONGENITAL HEART DISEASE; VACTERL.

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The Gastrointestinal System

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