Esophageal atresia
Esophageal atresia is a congenital medical condition (birth defect) which affects the esophagous (food pipe). It causes the esophagus to end in a blind-ended pouch rather than connecting normally to the stomach. It is characterized by a congenital obstruction of the esophagus with interruption of its continuity . Tracheoesophageal fistula (TEF) represents an abnormal opening between the trachea and esophagus. EA and TEF can occur separately or together.
Incidence
It occurs in approximately 1 in 2500 live births.
Diagnosis and Clinical presentation:
Prenatal ultrasound: Finding of a small or absent stomach bubble and associated with maternal polyhydramnios (excessive amniotic fluid). Predictive value of prenatal ultrasound is only 20%.
Postnatally: Most infants are symptomatic within first few hours of life. There is excessive salivation due to pooling of secretions in pharynx. Typically first feeding is followed by regurgitation, choking and coughing. Others features are cynosis (blue baby) with or without feeds and respiratory distress. If any of the above signs/symptoms are noticed, a catheter/ infant feeding tube is passed gently yhrough mouth or nose. Inability to pass the tube till stomach which is confirmed by x-ray confirm the diagnosis.