Oesophageal atresia describes a blind-ended oesophagus. A tracheo-oesophageal fistula is where there is communication between the trachea and oesophagus.

Epidemiology

• 10% are purely an oesophageal atresia
• 85% have a blind proximal oesophagus with the distal oesophagus having a fistula with the trachea
• 5% will have fistulae in both the proximal and distal oesophagus

Presentation

• Antenatal:
  • Polyhydraminos. As the oesophagus is blind-ending, fluid cannot pass through the baby to be absorbed. This results in an accumulation of fluid outside the baby – hence the polyhydramnios.
• Postnatal:
  • Respiratory distress
  • Distended abdomen
  • Choking/problems with swallowing. The baby will have difficulty feeding and has overflow saliva.
  • Neonatal doctors will find difficulty passing NG tubes down

Management

• Oesophageal atresia requires surgical management to correct the anatomical abnormalities