Oesophageal Atresia

Abstract

Oesophageal atresia is defined as an interruption in the continuity of the oesophagus, with or without fistula to the trachea. The anomaly results from an insult occurring in the fourth week of gestation, the time when the separation of trachea and oesophagus by folding of the primitive foregut normally takes place. Familial cases affecting siblings or offspring suggest genetic factors. Most cases occur sporadically, however, without evidence for either hereditary or specific environmental teratogenic causes. The incidence is approximately 1:4500 live births, with a slight male preponderance (59%). Associated malformations are obvious or easily detected in 40–60% of cases and may be found in up to 80% by a meticulous search for structural and numerical anomalies in the skeletal system. At least 18 different syndromes have been reported in association with oesophageal atresia. The best known is probably the VATER or VACTERL association of anomalies (Vertebral-Anal-Cardiac-Tracheal-Esophageal-Renal-Limb).