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oesophageal atresia

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Lower esophageal ring

Oesophageal atresia is a condition in which the oesophagus is not fully developed. It is a congenital condition, which means that it is present at birth.

What is going on in the body? 
Oesophageal atresia is a condition in which the upper oesophagus is closed off, forming a pouch at the end of it. This prevents fluid from entering into the stomach. The fluid builds up in the pouch and backs up into the mouth.

This condition is often associated with a tracheoesophageal fistula, an abnormality in which the lower oesophagus connects to the trachea. The trachea is the tube that allows air to flow between the lungs and mouth.

A baby with oesophageal atresia often has other medical problems, such as heart, kidney, or gastrointestinal conditions.

What are the signs and symptoms of the disease? 
Oesophageal atresia may be apparent soon after a baby is born. Signs and symptoms may include:
  • excess amniotic fluid in the amniotic sac
  • immediate feeding problems
  • coughing, gagging, and choking during feedings
  • thick and excessive respiratory secretions
  • cyanosis, which is a bluish colouration of the skin and mucous membranes
  • noisy breathing, such as wheezing
  • regurgitation
  • excessive drooling
  • trouble breathing, or shortness of breath
  • swollen abdomen
What are the causes and risks of the disease? 
Oesophageal atresia occurs when the oesophagus and trachea fail to separate normally while the embryo is in the uterus. The actual cause of this condition is not known. It is more common in babies with chromosomal abnormalities, such as Down syndrome.

What can be done to prevent the disease? 
At this time there is no way to prevent oesophageal atresia.

How is the disease diagnosed? 
To diagnose oesophageal atresia, a doctor will start with a complete medical history and physical examination. The doctor may then order tests, such as:
  • blood tests
  • chest x-rays and other x-rays
  • a special chest x-ray that is done after a nasogastric tube is put through the nose into the oesophagus to the point where the oesophagus stops
  • cinefluorography, which is a scan of the inside of the
What are the long-term effects of the disease? 
If diagnosed and treated early, oesophageal may cause few long-term effects. These may include pneumonia from aspirating and choking on stomach secretions. gastro-oesophageal reflux disease (GORD), a condition in which food goes up the oesophagus from the stomach, can also occur.

What are the risks to others? 
Oesophageal atresia poses no risk to others.

What are the treatments for the disease? 
A baby born with oesophageal atresia needs surgery right away. The type and extent of surgery will depend on what type of oesophageal atresia is present and what other congenital defects may exist. Surgery focuses on attaching the two ends of the oesophagus together and repairing any tracheoesophageal fistula that may be present.

What are the side effects of the treatments? 
Side effects depend on the treatments used. For example, antibiotics may cause allergic reactions and stomach upset. Surgery carries a risk of bleeding, infection, and allergic reactions to anaesthesia. Surgical repair of oesophageal atresia can increase the infant's risk of hiatal hernia and gastro-oesophageal reflux disease.

What happens after treatment for the disease? 
Catheters and special suction tubes will usually remain in place after surgery while the baby recovers from surgery and any secondary infection. Special x-rays or scans, such as an endoscopy, may be done to see if treatment is working. Further treatment will depend on any other conditions that exist. Encouraging bonding between parents and child is important in helping the child and family heal.

How is the disease monitored? 
Monitoring of oesophageal atresia will depend on the extent of symptoms and surgery done. The doctor should be notified of any new or worsening symptoms.

Author: Eileen McLaughlin, RN, BSN
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.

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