Esophageal atresia

Case contributed by Sadikun Nabi , 2 Jan 2022
Diagnosis certain
Changed by Henry Knipe, 3 Jan 2022

Updates to Case Attributes

Presentation was changed:
Respiratory distress, choking and cyanosis during attempted feeding.
Body was changed:

The majority of babies (86%) with OA has oesophageal atresia with(OA) have a distal tracheo-oesophageal fistula.Pure. Pure OA (without fistula) is much less common occurring in approximately (6%) of total cases. 

Clinical findings

  • Respiratory distress
  • Aspiration
  • Choking
  • Drooling
  • Difficulty handling secretions​

Imaging findings

Prenatal ultrasound - polyhydramnios may be detected.

chestChest x-ray -Radiolucent - radiolucent, blind-end dilated pouch of the upper oesophagus may be seen with failure to pass NG tube into the stomach. The characteristic feature of pure congenital oesophageal atresia and no fistula is a gasless abdomen in the presence of oesophageal atresia.

Types

The five subtypes of oesophageal atresia (Gross and Vogt Classification) are as follows:

  • type A: isolated oesophageal atresia (8%)
  • type B: proximal fistula with distal atresia (1%)
  • type C: proximal atresia with distal fistula (85%)
  • type D: double fistula with intervening atresia (1%)
  • type E: isolated fistula (H-type) (4%)
  • -<p>The majority of babies (86%) with OA has oesophageal atresia with distal tracheo-oesophageal fistula.Pure OA (without fistula) is much less common occurring in approximately (6%) of total cases. </p><p><strong>Clinical findings</strong></p><ul>
  • +<p>The majority of babies (86%) with oesophageal atresia (OA) have a distal tracheo-oesophageal fistula. Pure OA (without fistula) is much less common occurring in approximately (6%) of total cases. </p><p><strong>Clinical findings</strong></p><ul>
  • -</ul><p><strong>Imaging findings</strong></p><p><strong>Prenatal ultrasound </strong>- polyhydramnios may be detected.</p><p><strong>chest x-ray</strong> -Radiolucent, blind-end dilated pouch of the upper oesophagus may be seen with failure to pass NG tube into the stomach. The characteristic feature of pure congenital oesophageal atresia and no fistula is a gasless abdomen in the presence of oesophageal atresia.</p><p><strong>Types: </strong></p><p>The five subtypes of oesophageal atresia (Gross and Vogt Classification) are as follows:</p><ul>
  • -<li>
  • -<strong>type A:</strong> isolated <a href="/articles/oesophageal-atresia">oesophageal atresia</a> (8%)</li>
  • -<li>
  • -<strong>type B:</strong> proximal fistula with distal atresia (1%)</li>
  • -<li>
  • -<strong>type C:</strong> proximal atresia with distal fistula (85%)</li>
  • -<li>
  • -<strong>type D:</strong> double fistula with intervening atresia (1%)</li>
  • -<li>
  • -<strong>type E:</strong> isolated fistula (H-type) (4%)</li>
  • +</ul><p><strong>Imaging findings</strong></p><p>Prenatal ultrasound - polyhydramnios may be detected.</p><p>Chest x-ray - radiolucent, blind-end dilated pouch of the upper oesophagus may be seen with failure to pass NG tube into the stomach. The characteristic feature of pure congenital oesophageal atresia and no fistula is a gasless abdomen in the presence of oesophageal atresia.</p><p><strong>Types</strong></p><p>The five subtypes of oesophageal atresia (Gross and Vogt Classification) are as follows:</p><ul>
  • +<li>type A: isolated <a href="/articles/oesophageal-atresia">oesophageal atresia</a> (8%)</li>
  • +<li>type B: proximal fistula with distal atresia (1%)</li>
  • +<li>type C: proximal atresia with distal fistula (85%)</li>
  • +<li>type D: double fistula with intervening atresia (1%)</li>
  • +<li>type E: isolated fistula (H-type) (4%)</li>

References changed:

  • Radiologic diagnosis of tracheoesophageal fistula in children Ercan Ayaz https://ccts.amegroups.com/article/view/45911/htmlAyaz E & Haliloglu M. Radiologic Diagnosis of Tracheoesophageal Fistula in Children. Curr Chall Thorac Surg. 2021. <a href="https://doi.org/10.21037/ccts-20-161">doi:10.21037/ccts-20-161</a>
  • https://radiopaedia.org/cases/tracheo-oesophageal-fistula-types-diagrams-1
  • Radiologic diagnosis of tracheoesophageal fistula in children Ercan Ayaz https://ccts.amegroups.com/article/view/45911/html

Systems changed:

  • Paediatrics

Tags changed:

  • neonate

Updates to Study Attributes

Caption was removed:
Chest x ray AP

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