Esophageal atresia: Embryogenesis and management

Publisher Website
Google Scholar
Abstract
The embryogenesis of esophageal atresia is reviewed. Esophageal atresia is frequently associated with other predictable anomalies and prematurity. The management of esophageal atresia will vary according to the size and vigor of the baby, the severity of complicating anomalies, and the distance between the 2 esophageal ends. Surgical repair is not urgent, since the infant can be maintained by sump suction of the proximal esophagus to prevent aspiration of mucus and by gastrostomy or jejunal feedings. When associated anomalies or pulmonary complications have been resolved, the definitive repair is performed. If there is a long distance between the esophageal ends, it is usually possible over a period of time to bring the 2 ends close together by bougie stretching and by performing a series of esophageal myotomies. Complications that should be anticipated following repair include anastomotic stricture, recurrent tracheoesophageal fistula, esophageal dysmotility, tracheomalacia, and gastroesophageal reflux with aspiration, impaired caloric intake, and esophagitis.