Oesophageal atresia: a handshake with malrotation

Oesophageal atresia and tracheo-oesophageal fistula patients are known to have associated anomalies. Malrotation is a dangerous diagnosis to miss. The association of oesophageal atresia and tracheo-oesophageal fistula with malrotation is known but not quantified and certainly not emphasised enough in the literature. We retrospectively studied our population of oesophageal atresia and tracheo-oesophageal fistula patients to look for an associated malrotation. Ninety-one patients with oesophageal atresia were reviewed during 1978 - 1997, of whom 60 patients had an upper gastrointestinal study. Three of these patients (5 %) were noted to have malrotation. We would recommend a routine post-operative upper gastrointestinal study to look for abnormalities of intestinal rotation along with other information that can be obtained by the study. We also recommend that in patients with pure atresia, at the time of gastrostomy, intestinal rotation should be determined. All clinicians dealing with infants with oesophageal atresia should be aware of this association.