Types, Symptoms and Treatment of Esophageal Artesia

Esophageal Artesia

(EA) is a congenital defect in which the the esophagus (the muscular tube which connects the mouth to the stomach) is malformed. The esophagus is blocked off in blind pouches instead of opening into the stomach. The incidence of this disease is about 1 in 4000 births.
The esophagus could have two blind pouches, namely, upper and lower. In 86% of the cases, it is connected to the trachea ( windpipe leading to the lungs) by an abnormally formed passage way called the fistula. The latter condition is called Tracheoesophageal fistula (TEF).

Esophageal Artesia

Types of Esophageal Artesia

  • Long Gap or Isolated EA

    : This type has a long gap between the two blind pouches. No abnormal passage way or fistula is present between the esophagus and the trachea.

  • EA with Proximal TEF

    : The upper blind pouch connects to the trachea through a fistula.The lower pouch has a blind ending.

  • EA with distal TEF

    : This time the lower blind pouch connects to the trachea through a fistula. The upper pouch has a blind ending.

  • EA with both proximal and distal TEF

    : In this condition the upper and lower blind pouches make separate connections to the trachea through two separate fistulas in two isolated locations.

  • TEF only with no EA

    : The esophagus has no blockage in this case but it is connected to the trachea through one or more fistulas. The incidence of this condition is extremely rare.

  • Esophageal Stenosis

    : This condition can remain undiagnosed till adult years of life unlike the other forms of EA. The esophagus is structurally intact and fully functioning except that it gets gradually constricted and abnormally narrowed causing food and saliva to get clogged up creating blockage.

Symptoms of the condition

  • Throwing up, coughing, gagging, choking when trying to feed an infant.
  • Skin turning blue on feeding. This is also known as Cyanosis.
  • Poor feeding.

Surgical repair

Diagnosis of the condition

  • Prenatal ultrasound may show too much amniotic fluid, which can be an indication of this congenital defect.
  • A X-ray on new borns can detect the presence of an air filled blind pouch and air in the stomach and intestine.
  • On attempting to insert a feeding tube, it will not pass into the stomach and will appear coiled up in the upper esophagus on taking a X-ray.

Treatment of Esophageal Artesia

Generally emergency surgery is required to repair the esophagus and set its connections right. The fistulas are closed off and the esophagus is cleared of blockages and the two ends are connected together. Otherwise, there is a risk of the lungs being damaged.

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