2003-01-14-09 Esophageal atresia with tracheo-esophageal fistula © Vijayaraghavan www.thefetus.net/
Esophageal atresia with tracheo-esophageal fistula
Boopathy Vijayaraghavan, MD, DMRD1, V.Shanmugavadivu, MBBS2
1 SONOSCAN, Ultrasonic Scan Centre, 16B, Venkatachalam Road, R.S.Puram; 2 Consultant Obstetrician, Nalini Hospital,Thirupur
Prevalence: esophageal atresia occurs 3.3:10,000 births. Esophageal atresia with distal TEF is the most common form (87%), isolated esophageal atresia (8%) and isolated TEF (5%).
25-year-old woman GII PI was referred for sonography to rule out fetal anomalies, because of hydramnios. She has one live female child of 4 years. There is no history of consanguinity. The period of gestation by LMP was 34 weeks. Fetal biometry corresponded to 34 weeks. There was polyhydramnios.
Figure 1 shows normal stomach bubble of good size.
Figure 2 shows a coronal scan fetal neck, showing fluid filled blind ending esophageal pouch.
Figure 3- similar section after a while shows emptying of the pouch.
The features are diagnostic of esophageal atresia with TEF. The patient went into preterm labor 10 days after the scan. A feeding tube passed returned back confirming esophageal atresia. The x-ray showed air in the stomach confirming TEF. The child developed respiratory distress and died in half an hour. Parents declined autopsy.
Associated anomalies: other malformations-gastrointestinal (21%), cardiovascular (20%), urogenital (10%) and skeletal (20&). It may be part of VATER association. 7% will have aneuploidy.
Recurrence risk: Not known.
S.Boopathy Vijayaraghavan: Antenatal Diagnosis of Esophageal Atresia with Tracheoesophageal Fistula. J Ultrasound Med 15:417-419,1996
G.Centinit, L.Rosignoli, A.Kenanidis & F.Petraglia: Prenatal diagnosis of esophageal atresia with the pouch sign. Ultrasound Obstet Gynecol 21: 494-497,2003.