Esophageal atresia and tracheoesophageal fistula : a study of 100 cases

Abstract EN

BACKGROUND : Esophageal Atresia presents a challenging congenital abnormality which is incompatible with life and was referred to as "hopeless from the beginning and not of much practical importance to the surgeon"(1) is now successfully repaired all over the world.

AIM OF THE STUDY : to study the clinical presentation, diagnosis, types, management and complications of esophageal atresia in children admitted to welfare Teaching Hospital.

PATIENTS AND METHODS : A retrospective analysis of data of 100 neonates with esophageal atresia with or without tracheoesophageal fistula treated and followed up in children welfare Teaching Hospital, between January 2003 to January 2005.

RESULTS : Prenatal history of Polyhydramnios was evident in 77 (77%) cases.

(65%) were males and (35%) were females with male to female ratio was 1.8:1 The presenting features were frothy secretions from the mouth and failure to pass nasogastric tube in 98 ( 98%) cases, chocking after feeding in 87 (87%) cases, dyspnea in 12 ( 12%) cases, cyanosis in 50 (50%) cases, chest infection in 40 ( 40%) cases, most of the patients 92 (92%) cases were of the common type (proximal atresia with distal fistula), while 7 ( 7 % ) cases were of pure atresia type(without fistula), 1 (1%) case was of H-type fistula.

Associated anomalies were present in 23 (23%) cases.

Post operative complications were anastomotic leak seen in 24.6%, stricture seen in 18.5%, recurrent tracheoesophageal fistula in 2.

4% and mortality rate was high constituted 65%.

CONCLUSION : Esophageal atresia with distal fistula was the commonest type in this study.

Frothy secretion from the mouth, failure to pass nasogastric tube, chocking after feeding and Radiological study (Plain X-ray) were the main diagnostic features.

Delay in diagnosis and associated anomalies were responsible factors for increasing incidence of mortality and morbidity.