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[Vertebral abnormalities and atresia of the esophagus]
Insights
Musculoskeletal anomalies, particularly vertebral issues like thoracic hypersegmentation, are common in infants with esophageal atresia. These findings aid surgical planning for esophageal atresia, without significantly impacting outcomes.
Area of Science:
- Pediatric Surgery
- Developmental Biology
- Orthopedics
Context:
- Esophageal atresia (EA) is a congenital condition affecting infants.
- Musculoskeletal anomalies frequently co-occur with EA.
- Understanding these associations is crucial for comprehensive patient care.
Purpose:
- To investigate the prevalence and types of musculoskeletal anomalies in infants with EA.
- To identify specific vertebral anomalies associated with EA subtypes.
- To assess the impact of vertebral anomalies on surgical outcomes.
Summary:
- A study of 50 infants with EA revealed a 34% incidence of musculoskeletal anomalies, with 30% showing vertebral column abnormalities.
- V.A.T.E.R. syndrome was present in 10% of cases.
- Isolated thoracic hypersegmentation was the most frequent vertebral anomaly, consistently linked to Vogt type 3a EA with a significant gap between esophageal ends.
Impact:
- The identified association between thoracic hypersegmentation and Vogt type 3a EA is vital for surgical approach selection.
- The presence of an extra vertebral segment did not significantly increase anastomotic leakage or mortality rates in this series.
- Vertebral anomalies were infrequent in Waterston's risk group A.
Abstract:
Out of a series of 50 infants suffering from oesophageal atresia, muscular-skeletal anomalies were found in 17 of them (34%), and in 15 of these the vertebral column was abnormal (30%). 5 (10%) were affected by V.A.T.E.R. syndrome. The most frequent vertebral anomaly was characterised by isolated thoracic hypersegmentation, which was found to be regularly associated with Vogt type 3a of oesophageal atresia, with a large distance between the two ends of the oesophagus. This represents an important factor in determining the correct surgical approach, even if in this series the presence of an extra segment did not seem to significantly increase the rate of anastomotic leakage or of mortality. Vertebral anomalies in risk group A, according to Waterston's classification, were quite uncommon.