Why Choose Cedars Sinai Marina del Rey Hospital for Esophageal Atresia Treatment?
Since 1969, our hospital has been providing quality healthcare and treatment to the community of Los Angeles and we permanently strive to improve our services. By virtue of the state-of-the-art technology Cedars Sinai Marina del Rey Hospital is equipped with, we can perform surgery to treat esophageal atresia in infants with minimal postoperative risks. Our experienced and talented surgeons have a vast knowledge of birth defects and will be able to safely and effectively restore the health of your child within the shortest time possible.
The esophagus is the tube that connects the mouth to the stomach and is thereby a very important part of the digestive system. However, in some cases, infants are born with esophageal atresia, a birth defect in which the esophagus has two separate sections, the upper and the lower esophagus, that do not connect. As a consequence, a baby with this condition is unable to pass food from the mouth to the stomach and may also experience difficulty breathing. Prompt surgical intervention is the key to restoring their health, as esophageal atresia can lead to serious health complications if left untreated, such as aspiration pneumonia.
Oftentimes, esophageal atresia occurs with tracheoesophageal fistula, a congenital medical condition in which a portion of the esophagus is connected to the windpipe. In other words, esophageal atresia causes the esophagus to end in a pouch instead of connecting to the stomach. For this reason, the infant needs to undergo surgery, as they will be unable to be fed otherwise. According to estimates, 1 in every 4,100 babies is born with esophageal atresia in the United States every year. While the birth defect can occur by itself, it often occurs with other congenital medical conditions.
The most effective treatment for esophageal atresia is surgery, which entails the medical professional connecting the two ends of the esophagus so that the infant can breathe and be fed properly. In many cases, multiple surgical procedures are necessary to correct esophageal atresia, as it is a complex birth defect. For instance, following the first surgery, the esophagus of the infant may become too narrow for food to pass through it, in which case a second surgery is necessary. The muscles of the newly repaired esophagus may also not work properly to move food into the stomach or once ingested, the food may travel back up into the esophagus after the initial surgery. It is worthy of note that in a small number of cases, the gap between the upper and lower esophageal portions may be too long to connect to each other. In this case, the surgical approach implies gastrostomy followed by gastric pull-up, colonic transposition, and jejunum transposition.
Thereby, there are multiple surgical approaches for the treatment of esophageal atresia, such as:
- the Foker process: this novel technique stimulates the upper and the lower segments of the esophagus so that they can continue growing inside of the baby, which allows the surgeon to join the two portions of the esophagus together several days or weeks later
- static internal traction: this procedure also provides some esophageal growth and can thereby shorten the time your baby spends under anesthesia
- dynamic internal traction: this is another way of growing the esophagus that may be applicable in some cases to shorten the time the baby needs to spend under anesthesia
- primary anastomosis: this surgical procedure connects the esophageal gap so that the baby can breathe and be fed properly
- jejunal interposition: this surgical approach uses a portion of the middle part of the small intestine as a replacement for the missing segment of the esophagus and is associated with minimal postoperative risks, as well as with a fast recovery
There are 4 types of esophageal atresia that can be present in a baby at birth, namely:
- type A: in this type of esophageal atresia, the upper and the lower portions of the esophagus do not connect and have closed ends, with no segment of the esophagus being attached to the trachea
- type B: this is a very rare type of esophageal atresia, which entails the upper portion of the esophagus being attached to the trachea and the lower portion of it being closed at the end
- type C: as the most common type of esophageal atresia, this type involves the upper part of the esophagus having a closed end and the lower portion of the esophagus being attached to the trachea
- type D: this is the rarest, as well as the most severe, type of esophageal atresia, in which the upper and the lower portions of the esophagus are not connected to each other, but are separately attached to the trachea
Symptoms of Esophageal Atresia
If you notice one or more of the following symptoms in your baby soon after their birth, they may have been born with esophageal atresia:
Diagnosis of Esophageal Atresia
As a condition rarely diagnosed during pregnancy, esophageal atresia is usually detected shortly after birth, when the infant first tries to feed and experiences choking or vomiting or when a tube is inserted through their nose or mouth and it cannot pass down into the stomach. If this is the case, X-rays can confirm the presence of esophageal atresia. Another useful diagnostic tool when it comes to esophageal atresia is ultrasound, which can diagnose this condition even during pregnancy. It is important to note that pregnancies in which esophageal atresia occurs commonly develop excessive amniotic fluid, which is known as polyhydramnios.
At the moment, medical researchers do not exactly know what causes esophageal atresia in babies. However, they found several risk factors that may contribute to the development of this birth defect, such as:
- mutations to genes that may cause the esophagus to develop abnormally
- having a father who was over the age of 40 at the moment of conception
- undergoing fertility treatments such as intrauterine insemination and in vitro fertilization
While esophageal atresia is a birth defect that can usually not be prevented, you can lower the chances of your baby having this condition by: