Esophageal Atresia and Tracheoesophageal Fistulas

If the trachea and esophagus fail to completely separate by 35 days of gestation, it can result in one of several anomalies. The most commonly seen type (85%) is that of a blind upper esophageal pouch and a distal esophageal segment which is connected to the trachea (Type C). It usually presents as abdominal distension, feeding intolerance, and pneumonia in the newborn. As many as half of these cases may be associated with other components of the VATER complex of anomalies (vertebral, anal, tracheoesophageal, and radial/renal). Treatment involves closure of the fistula with primary anastomosis of the esophagus without tension. In the unstable infant, repair is delayed and initial treatment is G tube placement with division of the TE fistula.

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