What is esophageal atresia?

The esophagus — the tube that normally carries food from the mouth to the stomach — does not develop properly before birth. In most cases, the upper esophagus ends and does not connect with the lower esophagus and stomach. The top end of the lower esophagus connects to the windpipe. This connection is called a tracheoesophageal fistula (TEF). Some babies with TEF also have other problems, such as heart or other digestive tract disorders.

Other types of esophageal atresia involve narrowing of the esophagus, and may be associated with other birth defects.

Symptoms

• Bluish coloration to the skin (cyanosis) with attempted feedings
• Coughing, gagging, and choking with attempted feeding
• Drooling
• Poor feeding

Diagnosis

An ultrasound performed on the pregnant mother may show too much amniotic fluid, which can be a sign of esophageal atresia or other blockage of the digestive tract. But the disorder is usually detected shortly after birth when feeding is attempted and the infant coughs, chokes, and turns blue. As soon as esophageal atresia is suspected, a small feeding tube is passed through the mouth or nose into the stomach. 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 has been inserted, it will appear coiled up in the upper esophagus.

Treatment

Esophageal atresia is considered a surgical emergency. Surgery to repair the esophagus should be done quickly after the baby is stabilized so the lungs are not damaged and the baby can be fed.

Recovery:

Child will be NICU after surgery. Typically they take 7 to 10 days to recover and start feeding.

Prognosis:

Prognosis is usually good. Some may have leak at anastomosis after surgery which will have to be taken care. Stricture at anastomosis is the other problem during the follow up. These babies will require esophageal dilatations.