DefinitionEsophageal atresia is a birth defect in which the esophagus does not develop properly. The esophagus is the tube that normally carries food from the mouth to the stomach. CausesEsophageal atresia (EA) is a congenital defect. This means it occurs before birth. There are several types of EA. In most cases, the upper esophagus ends and does not connect with the lower esophagus and stomach. Most infants with EA have another defect called tracheoesophageal fistula (TEF). This is an abnormal connection between the esophagus and the windpipe (trachea). Often, infants with EA/TEF also have tracheomalacia. When this occurs, the walls of the trachea are weak and floppy, causing high-pitched or noisy breathing. At least half of babies with EA/TEF have other defects as well, most often heart defects. SymptomsSymptoms of EA may include:
Exams and TestsBefore birth, a mother's ultrasound may show more amniotic fluid than usual. This can be a sign of EA or other blockage of the unborn baby's digestive tract. If EA is present, the baby’s stomach may be hard to see on the ultrasound. EA is usually found shortly after birth when saliva and fluids collect in the esophagus. This causes your baby to cough, choke, and sometimes turn blue. Your baby's health care provider will try to pass a small feeding tube through your infant's mouth or nose into the stomach. If the feeding tube can't pass all the way to the stomach, your infant likely has EA. An x-ray may also show:
Once EA is confirmed, other tests may include:
TreatmentEA is an emergency. Surgery is done as soon as possible after birth.
Before the surgery, and for some time afterward, your baby is not fed by mouth. Instead, your baby is fed either:
Care is taken to keep your baby from breathing saliva or other fluids into the lungs. Outlook (Prognosis)An early diagnosis gives a better chance of a good outcome. Possible ComplicationsYour infant may breathe saliva or other fluids into the lungs, causing aspiration pneumonia, choking, and possibly death. Other complications may include:
Prematurity may complicate the condition. As noted above, there may also be defects in other areas of the body. When to Contact a Medical ProfessionalThis disorder is usually diagnosed shortly after birth. Contact your baby's provider right away if your baby vomits repeatedly after feedings, or if your baby develops breathing difficulties. ReferencesDingeldein M. Selected gastrointestinal anomalies in the neonate. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 84. Rothenberg SS. Esophageal atresia and tracheoesophageal fistula malformations. In: Holcomb GW, Murphy JP, St. Peter SD, eds. Holcomb and Ashcraft's Pediatric Surgery. 7th ed. Philadelphia, PA: Elsevier; 2020:chap 27. Wolf RB. Fetal abdominal imaging. In: Lockwood CJ, Copel JA, Dugoff L, et al, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 24. | |
| |
Review Date: 8/5/2023 Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. | |
| |
