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Esophageal Atresia

What It Is

Esophageal atresia is a birth defect in which a baby’s esophagus (the tube that passes food to the stomach) does not develop properly during gestation. While a baby’s esophagus normally extends from the back of the throat to the stomach, a baby born with esophageal atresia has a segment of esophagus missing or closed off. As a result, it is difficult or impossible for babies with esophageal atresia to feed in a normal manner. Most babies with esophageal atresia must feed intravenously until surgery can be preformed to correct the esophageal defect.

The majority of babies born with esophageal atresia also suffer from tracheoesophageal fistula. In a healthy baby, the esophagus and trachea are two different passageways; the esophagus carries food to the stomach, and the trachea is used for breathing. In babies who suffer from tracheoesophageal fistula, the two tubes are connected. This connection can be hazardous to the baby, both because it renders normal feeding impossible and it can cause difficulty breathing and damage to the lungs.

Esophageal atresia occurs in about one in every 4,000 births in the United States. Approximately one half of babies born with this condition also suffer from other birth defects.

Symptoms

  • Choking, gagging or coughing during attempted feedings
  • Skin turning a bluish hue during feedings
  • Frothy bubbling in the baby’s mouth
  • Drooling
  • Vomiting
  • Difficulty breathing
  • Bulbous abdomen

Causes

Clomid: According to a study of birth defects conducted by the Centers for Disease Control and Prevention (CDC), prenatal use of the fertility drug Clomid may be linked to an increased chance of delivering a baby with esophageal atresia. The study, which looked at birth records over the period of nearly a decade, uncovered that mothers who took Clomid in the two months prior to conception or during the first month of pregnancy, were 2.3x more likely to have a baby with esophageal atresia.

Treatment

Esophageal atresia is a condition that requires surgery. Surgery must sometimes be preformed as soon as possible in order to allow normal feeding and prevent damage to the lungs, but usually it is preformed between two and six months of age. Ideally, surgery will entail joining the disconnected segments of the esophagus. However, in more extreme cases called long-gap esophageal atresia, the space between the disjointed esophagus is too great and different surgical techniques must be used. For babies suffering from long-gap esophageal atresia, treatment options include:

  • Inserting an artificial esophageal extension tube
  • Repositioning the stomach so that it is attached directly to the throat
  • Transplanting a portion of the colon or small intestine tissue to extend the esophagus
  • Preforming a two-part surgery that creates traction on the esophagus, elongating it to a point where it can be connected

Although esophageal atresia can be life threatening, the majority of children with this condition can recover fully with early detection and treatment.

 

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