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Review
. 2012 Jul 28;18(28):3662-72.
doi: 10.3748/wjg.v18.i28.3662.

Current knowledge on esophageal atresia

Paulo Fernando Martins Pinheiro  1 , Ana Cristina Simões e Silva, Regina Maria Pereira
Affiliations
Review

Current knowledge on esophageal atresia

Paulo Fernando Martins Pinheiro et al. World J Gastroenterol. .

Abstract

Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is the most common congenital anomaly of the esophagus. The improvement of survival observed over the previous two decades is multifactorial and largely attributable to advances in neonatal intensive care, neonatal anesthesia, ventilatory and nutritional support, antibiotics, early surgical intervention, surgical materials and techniques. Indeed, mortality is currently limited to those cases with coexisting severe life-threatening anomalies. The diagnosis of EA is most commonly made during the first 24 h of life but may occur either antenatally or may be delayed. The primary surgical correction for EA and TEF is the best option in the absence of severe malformations. There is no ideal replacement for the esophagus and the optimal surgical treatment for patients with long-gap EA is still controversial. The primary complications during the postoperative period are leak and stenosis of the anastomosis, gastro-esophageal reflux, esophageal dysmotility, fistula recurrence, respiratory disorders and deformities of the thoracic wall. Data regarding long-term outcomes and follow-ups are limited for patients following EA/TEF repair. The determination of the risk factors for the complicated evolution following EA/TEF repair may positively impact long-term prognoses. Much remains to be studied regarding this condition. This manuscript provides a literature review of the current knowledge regarding EA.

Keywords: Esophageal atresia; Esophageal stenosis; Gastro-esophageal reflux; Long-gap; Tracheoesophageal fistula.

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Figures

Figure 1
Figure 1
Classification of esophageal atresia/tracheoesophageal fistula. A: Esophageal atresia (EA) without tracheoesophageal fistula (TEF); B: Proximal TEF with distal EA; C: Distal TEF with proximal EA; D: Proximal and distal TEF; E: TEF without EA or “H”-type TEF.
Figure 2
Figure 2
Plain X-rays of the chest and abdomen of two neonates with esophageal atresia. A: The non-progression of an orogastric catheter in the blind esophageal pouch and the presence of air in the stomach diagnose esophageal atresia with distal tracheoesophageal fistula; B: The radiopaque tube in the blind esophageal pouch and the absence of air in the stomach identify esophageal atresia without tracheoesophageal fistula.
See this image and copyright information in PMC

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