Esophageal atresia is a condition in which the esophagus is not fully developed. It is a congenital condition, which means that it is present at birth.
Esophageal atresia is a condition in which the upper esophagus is closed off, forming a pouch at the end of it. This prevents fluid from entering into the stomach. The fluid builds up in the pouch and backs up into the mouth.
This condition is often associated with a tracheoesophageal fistula, an abnormality in which the lower esophagus connects to the trachea. The trachea is the tube that allows air to flow into and out of the lungs. A baby with esophageal atresia often has been born with other abnormalities, such as those of the heart, kidney, or gastrointestinal tract.
Esophageal atresia may be apparent soon after a baby is born. Signs and symptoms may include: excess amniotic fluid in the amniotic sacimmediate feeding problemscoughing, gagging, and choking during feedingsthick and excessive respiratory secretionscyanosis, which is a bluish coloration of the skin and mucous membranesnoisy breathing, such as wheezingregurgitationexcessive droolingtrouble breathing, or shortness of breathswollen abdomen
Esophageal atresia occurs when the esophagus and trachea fail to separate normally while the embryo is in the uterus. The actual cause of this condition is not known. It is more common in babies with chromosomal abnormalities, such as Down syndrome.
At this time there is no way to prevent esophageal atresia.
To diagnose esophageal atresia, a healthcare provider begins with a complete medical history and physical exam. The provider may then order tests, such as: blood testschest x-rays and other x-raysa special chest x-ray that is done after a nasogastric tube is put through the nose into the esophagus to the point where the esophagus stopscinefluorography, a moving X-ray scan to observe the function of the esophagus
If diagnosed and treated early, esophageal may cause few long-term effects. These may include pneumonia from aspirating and choking on stomach secretions. Gastroesophageal reflux disease (GERD), a condition in which food goes up the esophagus from the stomach, can also occur.
Esophageal atresia poses no risk to others.
A baby born with esophageal atresia needs immediate surgery. The type and extent of surgery will depend on what type of esophageal atresia is present and what other congenital defects may exist. Surgery focuses on attaching the two ends of the esophagus together and repairing a tracheoesophageal fistula if it is present.
Side effects depend on the treatments used. For example, antibiotics may cause allergic reactions and stomach upset. Surgery can by complicated by bleeding, infection, and allergic reactions to the anesthetic. Surgical repair of esophageal atresia can increase the infant's risk of developing hiatal hernia and gastroesophageal reflux disease later on.
Catheters and special suction tubes will usually remain in place after surgery while the baby recovers from surgery and any secondary infection. Special x-rays or scans, such as an endoscopy, may be done to see if treatment is working. Further treatment will depend on any other conditions that exist. Encouraging bonding between parents and child is important in helping the child and family heal.
Monitoring of esophageal atresia will depend on the extent of symptoms and surgery done. The healthcare provider should be notified of any new or worsening symptoms.
Proffesional Guide to Diseases, fifth edition, Springhouse, 1995
Harrison's Principles of Internal Medicine, Fauci, et al, 1998
[hyperLink url="http://www.aafp.org/afp/990215ap/990215c.html" linkTitle="www.aafp.org/afp/990215ap/990215c.html"]www.aafp.org/afp/990215ap/990215c.html[/hyperLink]