ABSTRACT
The first description of esophageal atresia (EA) is credited to Durston, who described EA in one of a pair of conjoined twins in 1670. In 1913, Richter proposed the first plan for its management, which comprised dividing the associated tracheoesophagal fistula and feeding the infant by gastrostomy until the “technical difficulties of an esophageal anastomosis” had been overcome. Unless the child has severe cardiac anomalies, significant chromosomal abnormalities, pulmonary complications, or major prematurity issues, survival is expected with rates now in excess of 90%. The first simplified scheme used to predict mortality was originally proposed by Waterston in the 1960s and updated by Spitz in 1994. Although prenatal ultrasonography is now widespread in most developed countries, the majority of EA cases are not diagnosed antenatally. Symptoms that develop in the neonatal period include inability to clear secretions from the mouth, cyanotic episodes with or without attempting to feed the infant, inability to swallow, and respiratory distress.
