[Esophageal atresia]

F Gottrand1, R Sfeir, C Thumerelle

  • 1Centre de référence des affections congénitales et malformatives de l'œsophage, faculté de médecine, université de Lille 2, pôle enfant, hôpital Jeanne-de-Flandre, 59037 Lille, France. frederic.gottrand@chru-lille.fr

Insights

Children operated for esophageal atresia often face long-term issues like reflux and dysphagia. Regular, lifelong follow-up is crucial for managing these frequent esophageal atresia complications.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Pulmonology

Context:

  • Esophageal atresia (EA) repair allows survival, but long-term sequelae are common.
  • Gastroesophageal reflux disease (GERD) affects a significant portion, leading to esophagitis and stenosis.
  • Tracheomalacia is prevalent, posing risks for respiratory distress.

Purpose:

  • To review the medium-term and late complications following surgical repair of esophageal atresia.
  • To highlight the frequency and impact of gastrointestinal, respiratory, and growth issues.
  • To emphasize the need for ongoing multidisciplinary care.

Summary:

  • Post-EA surgery, common complications include GERD (26-75%), dysphagia (up to 45% by age 5), and growth retardation (nearly 33% by age 5).
  • Respiratory issues like tracheomalacia (75% at birth) and chronic cough are frequent, though often improve.
  • These complications moderately impair quality of life, necessitating lifelong monitoring.

Impact:

  • Identifies critical areas for long-term management of EA patients.
  • Underscores the importance of multidisciplinary follow-up into adulthood.
  • Provides data on complication rates to inform clinical practice and patient counseling.

Related Concept Videos

Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
Esophageal Achalasia01:27

Esophageal Achalasia

Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide (VIP)...
Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Hiatal Hernia01:25

Hiatal Hernia

A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or heavy...