Learn About Esophageal Atresia
Esophageal atresia is a birth defect in which the esophagus does not develop properly. The esophagus is the tube that normally carries food from the mouth to the stomach.
Esophageal atresia (EA) is a congenital defect. This means it occurs before birth. There are several types of EA. In most cases, the upper esophagus ends and does not connect with the lower esophagus and stomach.
Most infants with EA have another defect called tracheoesophageal fistula (TEF). This is an abnormal connection between the esophagus and the windpipe (trachea).
Often, infants with EA/TEF also have tracheomalacia. When this occurs, the walls of the trachea are weak and floppy, causing high-pitched or noisy breathing.
At least half of babies with EA/TEF have other defects as well, most often heart defects.
Symptoms of EA may include:
- Bluish coloration to the skin (cyanosis), often with attempted feeding
- Coughing, gagging, and choking with attempted feeding
- Drooling or vomiting
- Poor feeding
EA is an emergency. Surgery is done as soon as possible after birth.
- First, any connection between the esophagus and the airway must be blocked. This will prevent damage to the lungs.
- The esophagus will be connected to the stomach. This may take time to complete, depending on the gap between the esophagus and the stomach.
Before the surgery, and for some time afterward, your baby is not fed by mouth. Instead, your baby is fed either:
- Through a gastrostomy tube (G-tube) so that your baby can be fed directly into the stomach, or
- Nutrition given through the veins
Care is taken to keep your baby from breathing saliva or other fluids into the lungs.
Erasmus MC
Dick Tibboel practices in Rotterdam, Netherlands. Mr. Tibboel is rated as an Elite expert by MediFind in the treatment of Esophageal Atresia. His top areas of expertise are Congenital Diaphragmatic Hernia, Diaphragmatic Hernia, Esophageal Atresia, Fasciotomy, and Endoscopy.
Aurora Internal Medicine
Dorota Wozniewicz is a primary care provider, practicing in Internal Medicine in Franklin, Wisconsin. Dr. Wozniewicz is rated as an Advanced provider by MediFind in the treatment of Esophageal Atresia. Her top areas of expertise are Esophageal Atresia, Esophageal Atresia Coloboma Talipes, High Cholesterol, and Hypothyroidism.
Johns Hopkins All Children's Hospital
Dr. Russell “Rusty” Jennings, a pioneer of pediatric surgical procedures for malformed esophageal and tracheal conditions, is a surgeon in the Esophageal and Airway Treatment (EAT) Program at Johns Hopkins All Children’s Hospital, which he joined in 2022. A pediatric surgeon for more than 40 years, Dr. Jennings founded and directed the world’s first Esophageal and Airway Treatment (EAT) Center at Boston Children’s Hospital. There he led a multidisciplinary team that worked on solving unsolved problems, and developed innovative techniques for evaluation, diagnosis and successful treatment of: complex esophageal strictures esophageal atresia “long gap” esophageal atresia esophageal replacement tracheo-esophageal fistulas recurrent tracheo-esophageal fistulas laryngo-tracheo-esophageal clefts tracheomalacia bronchomalacia tracheal reconstruction aberrant subclavian artery vascular compression syndromes vascular rings pectus excavatum chest wall deformities asphyxiating thoracic dystrophies recurrent laryngeal nerve monitoring during thoracic surgery Dr. Jennings has many publications on these topics including the largest series of successful treatment of complex recurrent tracheoesophageal fistulas in the literature with excellent outcomes, techniques to grow patients’ tissues to allow repair and connection of the esophagus in cases of esophageal atresia and esophageal injury, esophageal replacement with jejunum, and treatment of tracheomalacia. He has frequently taught and presented on these and numerous other related topics regionally, nationally, and internationally. Dr. Jennings’ prior work includes establishing the first fetal surgery center in New England; Dr. Jennings developed the first successful fetal cardiac surgery program in the world treating HLHS before birth. Dr. Jennings earned his medical degree from the University of California, San Francisco. His general surgery residency was done at the University of California, San Francisco. He was a postdoctoral research fellow for three years in the Fetal Treatment Center and Fetal Treatment Laboratory while completing the residency. He completed a pediatric surgery fellowship at Boston Children’s/Harvard Medical School. Dr. Jennings is rated as an Elite provider by MediFind in the treatment of Esophageal Atresia. His top areas of expertise are Esophageal Atresia, Tracheoesophageal Fistula, Gastrointestinal Fistula, Double Aortic Arch, and Endoscopy.
An early diagnosis gives a better chance of a good outcome.
Your infant may breathe saliva or other fluids into the lungs, causing aspiration pneumonia, choking, and possibly death.
Other complications may include:
- Feeding problems
- The repeated bringing up of food from the stomach (reflux) after surgery
- Narrowing (stricture) of the esophagus due to scarring from surgery
Prematurity may complicate the condition. As noted above, there may also be defects in other areas of the body.
This disorder is usually diagnosed shortly after birth.
Contact your baby's provider right away if your baby vomits repeatedly after feedings, or if your baby develops breathing difficulties.
Summary: Esophageal atresia is the most common congenital anomaly of the esophagus and is caused by abnormal development of the esophagus during intrauterine life. In children with esophageal atresia, structural abnormalities due to congenital anomalies and tracheoesophageal fistula, tracheomalacia, respiratory problems, recurrent respiratory tract infections, structural abnormalities, surgical interventio...
Summary: A transition consultation for adult patients with esophageal atresia, involving medical and paramedical stakeholders, was set up at Hôpital Saint-Louis in 2020. The aim of this initiative is to: 1. initiate adult medical, psychological and social follow-up; 2. empower these adults in their future care; 3. establish a personalized follow-up schedule. This project is the first to focus on post-traum...
Published Date: August 05, 2023
Published By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Dingeldein M. Selected gastrointestinal anomalies in the neonate. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 84.
Rothenberg SS. Esophageal atresia and tracheoesophageal fistula malformations. In: Holcomb GW, Murphy JP, St. Peter SD, eds. Holcomb and Ashcraft's Pediatric Surgery. 7th ed. Philadelphia, PA: Elsevier; 2020:chap 27.
Wolf RB. Fetal abdominal imaging. In: Lockwood CJ, Copel JA, Dugoff L, et al, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 24.