EA Flashcards
Type of EA
- Isolated EA (50%)
* Syndromic EA (50%)
Ratio isolated EA:syndrome EA
50%:50%
Syndrome EA
VACTERAL
CHARGE
VACTERAL
Vertebral, Anorectal, Cardiac, Tracheo- Esophageal, Renal, and Limb abnormalities
Charge syndrome
Coloboma
Heart defects Atresia of the choanae developmental Retardation Genital hypoplasia Ear deformities
Most common type of EA
Proximal atresia with distal fistula 85%
Second m/c type of EA
Pure atresia w/o fistula
Antenatal diagnosis
Nonnnnnn specific
Polyhydramnios
Absent or small stomach bubble
Time of Diagnosis
All diagnosis after birth
Postnatal diagnosis
- Excessive salivation
- Coiled feeding tube in the blind upper pouch around T2–T4 on chest x-ray
• Presence/absence of gas in the stomach and bowel on abdominal x-ray
→assign the type of EA
• +/- Contrast study
How we assign the type of EA
On abdominal X-ray
Presence/absence of gas in the stomach and bowel
Operative repair depends on
on the gap between esophageal ends
Operative repair depends on the gap between esophageal ends:
<2 vertebrae → primary anastomosis
2-6 vertebrae → gastrostomy + delayed primary
anastomosis
>6 vertebrae → gastrostomy + esophagostomy + esophageal replacement later on
Is EA emergency?
No
Benefits of open thoracotomy
Easier
Good outcome