ABSTRACT
Esophageal atresia with or without a tracheo-esophageal fistula (TEF) is one of the rarer congenital anomalies, occurring in 1/5000 births. Traditionally these patients have presented shortly after birth because of an inability to pass an oro-gastric tube, respiratory distress, or an inability to tolerate feeds. The condition may be associated with other major congenital anomalies (VATER syndrome) or may be an isolated defect. Improvements in maternal-fetal ultrasound have now resulted in prenatal diagnosis in a number of cases. This allows the surgeon to plan for delivery and eventual surgery. Patients with a TEF require emergency surgical intervention to prevent aspiration of gastric acid and over-distension of the intestines. Those with pure atresia can be dealt with electively as long as the infant’s oral secretions are controlled by continuous or intermittent suction.
