Oesophageal atresia

Question 1

What is the definition of congenital atresia

Answer 1

Congenital abscence of a segment of the oesophagus

Question 2

What is the presentation of oesophageal atresia

Answer 2

Polyhydramnios
Respiratory distress
Excessive salivation
Feeding intolerance
Unable to swallow saliva

Question 3

When is oesophageal atresia diagnosed

Answer 3

During first feeding - after swallowing

Immediate regurgitation of milk through mouth and nose

Choking, Coughing, Cyanosis

Question 4

What are the investigations for oesophageal atresia

Answer 4

CxR: coiling in upper oesophagus
Babygram
Cardiac echo
U/S - kidney, ureters and bladder
Genetic studies
Bloods

Question 5

What is the treatment involved in oesophageal atresia

Answer 5

Stabalize the patient - inubate if necessary
IV access - Glucose contaning fluid
NG tube - suction regularly

Transfer to tertiary hospital ASAP
Early operation
- Thoracotomy
- Division + suture of tracheo-oesophageal fistula
- Oesophageal anastomosis

Question 6

What do you do in the case that primary anastomosis due to long gap

Answer 6

Wait for oesophagus to grow
Gastrostomy to feed
Oesophagostomy in no other option
Plan replacementprocedure after 1 year of age: Colon or stomach

Question 7

Explain Gross type A oesophageal atresia

Answer 7

Atresia alone with no fistula
Usually have a long gap between the oesophageal ends

Question 8

Explain Gross type B oesophageal atresia

Answer 8

Proximal tracheoesophageal fistula but no distal fistula

Often has a long gap between oesophageal ends

Question 9

Explain Gross type C oesophageal atresia

Answer 9

Most common abnormality
Distal tracheooesophageal fistula

Question 10

Explain Gross type D oesophageal atresia

Answer 10

Proximal and distal fistulas - double fistulas

Question 11

Explain Gross type E oesophageal atresia

Answer 11

No atresia of the oesophagus but with a tracheo-oesophageal fistula

H or N fistula