Treatments for Congenital Anomalies of the Esophagus and Trachea in Children

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If your baby has a congenital anomaly of the esophagus or trachea, she will need surgery to fix the problem.

Esophageal atresia

Repair of esophageal atresia depends on how close the two sections of esophagus are to each other. It may involve the placement of a feeding tube in your child's stomach and may require one or more operations to repair over several months.

Esophageal atresia associated with a tracheoesophageal fistula

This condition can usually be repaired in the first day or two of your baby's life in one operation that involves surgically closing the connections between the esophagus and the trachea and connecting the two ends of the esophagus together. Children who undergo this procedure usually do very well.

Tracheal stenosis
This condition can be repaired by removing the narrowed or constricted part of your baby's trachea and then connecting the unaffected parts of the trachea.

Tracheal blockages
A blockage in the trachea, or short segment atresias of the trachea or larynx may require specialized surgical treatment during delivery called an EXIT (ex utero intrapartum treatment) procedure.

For this procedure, surgery is done as the baby is delivered via Cesarean section and still attached to the mother's placenta. This method gives surgeons time to perform multiple procedures to secure or open up the baby's airway while the blood flow and exchange of gases that normally occurs in the womb between the fetus and the placenta is preserved.

Your baby's surgeon and other physicians will decide when it is best to do the operations, based on your baby's condition and the type of problem.

Could my child have problems in the future?

Some children born with esophageal atresia have long-term problems. Swallowing food or liquids may be difficult due to:

  • problems with the normal movement of foods and liquids down the esophagus (peristalsis)
  • scarring that can occur in the esophagus after surgery as the wounds heal, which can partially block the passage of foods

Sometimes, a narrowed esophagus can be widened or dilated with a special procedure done while the child is under general anesthesia. In other cases, another operation may be necessary to open up the esophagus so food can pass to the stomach properly.

GERD

About one-half of children who had esophageal atresia repaired will have problems with gastrointestinal reflux disease.

Reflux causes acid to move up into the esophagus from the stomach. When acid moves from the stomach into the esophagus, it causes a burning or painful feeling known as heartburn.

Reflux can usually be treated with medications prescribed by a physician. In some cases, when there is poor response to medical treatment, the operative treatment of reflux may be necessary.

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