Esophageal atresia is a disorder in which the esophagus is obstructed due to a segment that has complete obliteration of the lumen. It occurs in a variety of subtypes, depending on whether, and at what level, the esophagus and trachea are connected. In the most common subtype, there is a fistulous connection between the trachea and the distal portion of the esophagus.|
Esophageal atresia can occur on its own or in conjunction with other structural anomalies. One of the anomaly groupings that includes esophageal atresia is the VATER grouping:
The prognosis is variable, depending in part on the presence or absence of associated anomalies.
The sonographic findings of esophageal atresia are little or no fluid in the fetal stomach and polyhydramnios. If there is no tracheoesophageal fistula (and hence no route by which amniotic fluid can reach the fetal stomach), there will be complete absence of fluid in the fetal stomach and severe polyhydramnios. If there is a distal tracheoesophageal fistula, amniotic fluid can traverse this fistula to reach the fetal stomach. In these cases, the degree of polyhydramnios may be variable and there may be some fluid in the fetal stomach.
The findings of polyhydramnios together with little or no fluid in the fetal stomach can also be present in fetuses with a facial or mouth lesion that obstructs swallowing (e.g., lower facial teratoma). Hence, when the sonogram demonstrates polyhydramnios and little or no fluid in the fetal stomach, the fetal face should be examined before concluding that the diagnosis is esophageal atresia.
When the diagnosis of esophageal atresia is made, the entire fetus should be carefully assessed for the presence of associated anomalies.
Transverse view of the fetal upper abdomen demonstrates severe polyhydramnios and no identifiable stomach.