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Oesophageal and intestinal atresias

OVERVIEW

The incomplete development of the oesophagus before birth leads to a disorder of the digestive system known as oesophageal atresia. The oesophagus is responsible for transporting food and liquids from the mouth to the stomach. As a result, oesophageal atresia can lead to problems such as choking and breathing difficulties and can prevent food from reaching the stomach after swallowing.

Oesophageal atresia is considered a congenital disability, which means that it is a birth defect that occurs during foetal development. It often co-occurs with another condition known as tracheoesophageal fistula, which involves an unusual connection between the oesophagus and the windpipe (trachea) instead of the stomach.

Types of oesophageal atresia

Oesophageal atresia is classified into different types based on the location of the abnormality in the oesophagus. The types of oesophageal atresia are:

Type A: This type is also known as "pure oesophageal atresia" or "long-gap oesophageal atresia" and involves both the upper and lower sections of the oesophagus having closed ends that do not connect.
Type B: This is a rare type of oesophageal atresia where the lower section of the oesophagus is closed, and the upper section connects to the trachea.
Type C: This is the most common type of oesophageal atresia, where the lower section of the oesophagus is connected to the trachea, and the upper section is closed.
Type D: In this rare form of oesophageal atresia, both ends of the oesophagus connect to the trachea.

Signs and symptoms of oesophageal and intestinal atresias

Symptoms of oesophageal atresia typically become apparent immediately after a baby is born. These signs may include:

Bluish skin colour during feeding
Choking, coughing, or gagging during feeding
Foamy mucus in the mouth
Spitting up or drooling
Difficulty breathing

Treatment

Due to the life-threatening nature of oesophageal atresia, prompt treatment is necessary for affected babies. The standard treatment involves a surgical intervention to connect the oesophagus to the stomach, which can be performed as an open or thoracoscopic procedure.

For otherwise healthy babies, surgery is typically performed within a few days of birth. However, infants with additional health complications or disabilities may need to wait before undergoing surgery for oesophageal atresia. In such cases, the baby will receive nutrition via an IV, which involves inserting a small tube into a vein until the surgery can take place.

REQUEST A CONSULTATION

Dr Mangray, the founder of KZN Specialised Paediatric Surgical Service, and his associates, Dr Ngobese, Dr Govender and Dr Dube-Zvirikuzhe, have a well-established reputation for caring for children right until late adolescence.

FREQUENTLY ASKED QUESTIONS

FAQ

1What are the possible complications of oesophageal atresia?

Complications of oesophageal atresia may include gastroesophageal reflux, aspiration pneumonia, feeding difficulties and stricture formation. In some cases, long-term feeding and respiratory problems may persist.

2 Can oesophageal atresia be prevented?

At present, there is no known method to avoid oesophageal atresia. However, prenatal care and genetic counselling may help identify certain risk factors that may increase the likelihood of having a baby with this condition.

3How is oesophageal atresia diagnosed?

Oesophageal atresia is typically diagnosed shortly after birth when a baby experiences difficulty feeding or shows signs of respiratory distress. Imaging tests such as X-rays may be used to confirm the diagnosis.