Babies with esophageal and duodenal atresia: a 30-year review of a multifaceted problem

Journal of Pediatric Surgery
Sigmund H EinRobert M Filler

Abstract

The purpose of this study was to review newborns with esophageal atresia (EA) with and without distal tracheoesophageal fistula (TEF) combined with duodenal atresia (DA) or duodenal stenosis (DS) (web, windsock, diaphragm) to determine which clinical features and treatments give the best results. Twenty-four newborns were reviewed from 1971 to 2000 inclusive. Seven had EA and 17 had EA with TEF; 15 had DA and 9 had DS. One died after receiving only a gastrostomy. Seven underwent repair of both defects in 1 stage, whereas 16 were repaired separately. Eighteen of 24 (75%) survived. The EA or EA with TEF was repaired first in 5, but the DA or DS was initially overlooked in 4 and 2 died. The DA or DS was repaired first in 11, and all survived. Of the 7 in whom both repairs were done at same setting, 4 survived. Of 6 nonsurvivors, 5 were repaired. Mortality from EA was greater than EA with TEF, and DA was greater than DS. Associated anomalies in 18 (75%) of 24 did not affect survival. Staged repair (ideally within 1 week) is a safe suitable method of management. In EA, the coexistence of DA or DS must be considered because delay in diagnosis may adversely affect outcome. Mortality is a multifactorial phenomenon.

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Citations

May 20, 2014·BMJ Case Reports·Ramnik V PatelAgostino Pierro
Dec 3, 2014·Seminars in Pediatric Surgery·Andrea ConfortiPietro Bagolan
Apr 4, 2015·Journal of Pediatric Surgery·Ana Catarina FragosoJuan A Tovar
Dec 3, 2014·International Journal of Surgery Case Reports·Christoph S NabzdykWalter J Chwals
Nov 28, 2017·Current Gastroenterology Reports·Hayat MousaChristophe Faure
Jan 9, 2018·Oxford Medical Case Reports·G MaldonadoJ Gonzalez
Sep 29, 2020·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·Maria Enrica MisciaPierluigi Lelli Chiesa
Feb 15, 2020·European Journal of Pediatrics·Aymeric AmelotMichel Zerah
May 5, 2009·Paediatrics & Child Health·Andrea HunterBrian H Cameron
May 1, 2021·Pediatric Reports·Raef JacksonSemiu E Folaranmi
Jun 15, 2007·Journal of Pediatric Surgery·Zornitza StarkAmanda Moody

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