Esophageal Atresia

Esophageal atresia is a disorder of the digestive system in which the esophagus does not develop properly. The breathing tube that connects the nose and mouth with the lungs is called the trachea. EA is a condition in which the proximal and distal portions of the esophagus do not communicate. Tracheoesophageal fistula (TEF) represents an abnormal opening between the trachea and esophagus. With esophageal atresia, the esophagus does not form properly while the fetus is developing before birth, resulting in two segments; one part that connects to the throat, and the other part that connects to the stomach It can occur at any level from the cricoid cartilage to the carina, although it usually courses obliquely (with the tracheal end proximal) at or above the level of the second thoracic vertebra. . The distal esophageal segment communicates with the trachea just above the carina. An H-type TEF represents a TEF without EA. The most common abnormality is EA with a distal TEF (84%). Isolated atresia with no fistula is the next most common finding (8%), followed by TEF with no atresia (so-called H type) (4%). If a TE fistula is also present, liquid that a baby swallows can pass through the connection between the esophagus and the trachea and go into the lungs EA and TEF can occur separately or together. EA and TEF are diagnosed in the ICU at birth and treated immediately.

Esophageal atresia (or Oesophageal atresia ) is a congenital medical condition ( birth defect ) which affects the alimentary tract . It just ends in a pouch, so nothing the baby swallows gets into the stomach. The disorder is a congenital defect, which means it occurs before birth. Esophageal Atresia is a condition in which the patient is born with an abnormality in the part of the digestive tube that runs from below the tongue to the stomach (esophagus). Since the esophagus is in two segments, liquid that a baby swallows cannot pass normally through the esophagus and reach the stomachThis surgery is used to repair two congenital defects of the airway and the digestive tract: tracheoesophageal fistula (TEF) and esophageal atresia . Subsequent to that child's survival and with advances in surgical and anesthetic techniques, esophageal atresia is now regarded as an eminently correctable congenital lesion. Symptoms of these disorders may be excessive salivation, choking, the return of swallowed food into the mouth, and/or a swollen abdomen when a Tracheoesophageal Fistula is present. If a TE fistula is also present, liquid that a baby swallows can pass through the connection between the esophagus and the trachea and go into the lungs. This can cause pneumonia and other problems.

Causes of Esophageal Atresia

The commom causes of Esophageal Atresia :

• This condition is frequently complicated by the infant's breathing saliva and secretions into the lungs, causing pneumonia , choking , and possibly death.
• We don't think these problems are inherited.
• Immediate surgical repair of this disorder is required so that the lungs are not damaged and the baby can be fed.
• At about four to eight weeks after conception, a wall forms between the fetus' esophagus and trachea to separate them into two distinct tubes.
• The esophagus is the tube that normally carries food from the mouth to the stomach.

Symptoms of Esophageal Atresia

Some common symptoms of Esophageal Atresia :

• Coughing, gagging, and choking associated with attempted feeding
• Bluish coloration to the skin (cyanosis) associated with attempted feedings
• Excessive salivation
• blue color of the skin, especially when the baby is feeding
• vomiting
• difficulty breathing
• Esophagus not connected to stomach
• Inability to swallow

Treatment of Esophageal Atresia

• Prophylactic broad-spectrum antibiotics (eg, ampicillin, gentamicin) are administered intravenously.
• The use of colonic (left chest or substernal), gastric pull-up, or jejunal vascularized graft segments is difficult and should be based on the condition of the infant, the pathologic anatomy, associated defects (eg, gastric pull-up is usually contraindicated in significant cardiac disease, colonic esophageal replacement is usually contraindicated with concomitant imperforate anus), and the surgeon's experience.
• expectations for the course of the condition
• The parents should be fully briefed about the nature of the congenital anomaly.
• opinion of the surgeon and other physicians involved in the baby's care
• Surgery to repair the esophagus is done quickly after the infant has been stabilized.
• your opinion and preference
• Before the surgery, the infant is not fed by mouth, and care is taken to prevent the infant from breathing secretions into the lungs.

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