Esophageal atresia is a birth defect in which the esophagus does not develop properly. The esophagus is the tube that normally carries food from the mouth to the stomach.

Esophageal atresia (EA) is a congenital defect. This means it occurs before birth. There are several types of EA. In most cases, the upper esophagus ends and does not connect with the lower esophagus and stomach.

Most infants with EA have another defect called tracheoesophageal fistula (TEF). This is an abnormal connection between the esophagus and the windpipe (trachea).

Often, infants with EA/TEF also have tracheomalacia. When this occurs, the walls of the trachea are weak and floppy, causing high-pitched or noisy breathing.

At least half of babies with EA/TEF have other defects as well, most often heart defects.

Symptoms of EA may include:

• Bluish coloration to the skin (cyanosis), often with attempted feeding
• Coughing, gagging, and choking with attempted feeding
• Drooling or vomiting
• Poor feeding

EA is an emergency. Surgery is done as soon as possible after birth.

• First, any connection between the esophagus and the airway must be blocked. This will prevent damage to the lungs.
• The esophagus will be connected to the stomach. This may take time to complete, depending on the gap between the esophagus and the stomach.

Before the surgery, and for some time afterward, the baby is not fed by mouth. Instead, the baby is fed either:

• Through a gastrostomy tube (G-tube) so that the baby can be fed directly into the stomach, or
• Nutrition given through the veins

Care is taken to keep the baby from breathing saliva or other fluids into the lungs.

An early diagnosis gives a better chance of a good outcome.

The infant may breathe saliva or other fluids into the lungs, causing aspiration pneumonia, choking, and possibly death.

Other complications may include:

• Feeding problems
• Reflux (the repeated bringing up of food from the stomach) after surgery
• Narrowing (stricture) of the esophagus due to scarring from surgery

Prematurity may complicate the condition. As noted above, there may also be defects in other areas of the body.

This disorder is usually diagnosed shortly after birth.

Contact your baby's provider right away if the baby vomits repeatedly after feedings, or if the baby develops breathing difficulties.

Published Date: July 18, 2021
Published By: Kimberly G. Lee, MD, MSc, IBCLC, Clinical Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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