Esophageal atresia type C with overlapping long upper pouch: A rare variant

Area of Science:

• Pediatric Surgery
• Embryology
• Neonatal Medicine

Background:

• Esophageal atresia is a frequent pediatric surgical emergency, particularly in developing nations.
• Complex embryologic development of the esophagus and trachea results in diverse esophageal atresia anomalies.
• Long upper esophageal pouch with distal tracheoesophageal fistula represents a rare esophageal atresia variant.

Observation:

• A neonate presented with respiratory distress and vomiting, with initial diagnosis of esophageal atresia missed due to nasogastric tube placement.
• Diagnosis was confirmed as type C esophageal atresia with a long upper pouch via X-ray and esophagogram.
• Surgical intervention was delayed beyond the third week of life due to diagnostic challenges.

Findings:

• The case highlights diagnostic challenges posed by uncommon esophageal atresia presentations.
• Delayed diagnosis and intervention did not preclude survival in this specific case.
• This rare esophageal atresia variant appears to have a favorable prognosis despite diagnostic delays.

Implications:

• Increased physician awareness of rare esophageal atresia types is essential to prevent diagnostic delays.
• Timely diagnosis and management are critical for improving outcomes in esophageal atresia cases.
• This case underscores the importance of considering esophageal atresia even with atypical presentations.