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September 1947

CONGENITAL ATRESIA AND TRACHEOESOPHAGEAL FISTULA: Four Consecutive Cases of Successful Primary Esophageal Anastomosis

Author Affiliations

From the Department of Surgery of the Johns Hopkins University School of Medicine and Johns Hopkins Hospital.

Arch Surg. 1947;55(3):330-338. doi:10.1001/archsurg.1947.01230080336008

THE this paper are presented with two purposes in mind: (1) to direct attention again to a congenital anomaly which if untreated is incompatible with life, but which now can frequently be satisfactorily corrected by surgical procedures, and (2) to discuss certain steps in the care of these patients which have not been emphasized in previous reports by others.

The most common congenital anomaly of the esophagus is complete atresia; the upper segment ends in a blind pouch and the lower segment communicates with the trachea near the bifurcation. It is now generally agreed that in these cases the esophagus should be explored, the fistula ligated and if possible an end-to-end anastomosis of the esophagus, as recommended by Haight,1 performed. If the anomaly is such that an anastomosis is not feasible, the oral segment is exteriorized, the fistula ligated at the trachea and a gastrostomy performed. The two external