used instead of a Replogle in a baby with EA, the suction can potentially entrain air
and/or oxygen that the baby has in the pharynx.
Work-Up
Chest X-ray and KUB
Cardiac ECHO --visualize cardiac
anomalies and the side of the aortic
arch & descending aorta. This
determines the side of the thoracotomy
for surgical repair.
Renal ultrasound
Spine ultrasound or Spine MRI at 3- 6
months (modality depends on the
institution)The overall prognosis is function of preoperative weight and presence of anomalies. In
a full term and no anomalies, there is nearly 100% survival. If the birthweight < 1.5 kg
and anomalies, there is about 50% survival.
Surgical Repair of Esophageal Atresia with Distal TEF
A primary repair of the TEF is considered if the child weighs greater than 1.5 kg,
with minimal respiratory compromise and no life threatening anomalies. Consideration
for a delay in fistula ligation and esophageal repair is given until the child reaches a
weight of at least 1.8- 2 kg. In patients where delayed repair is considered, a
gastrostomy tube may help decompress the stomach, drain gastric secretions and
decrease aspiration of gastric contents into the lung.. While waiting for weight gain, the
child would require suction of the esophageal pouch and parenteral nutrition. Some