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August 1970

Gastrointestinal-Tract Defects Associated With Esophageal Atresia and Tracheo-Esophageal Fistula: Surgical Management

Author Affiliations

From Cook County Children's Hospital and University of Illinois College of Medicine, Chicago.

Arch Surg. 1970;101(2):241-244. doi:10.1001/archsurg.1970.01340260145023

During the past ten years at the Cook County Children's Hospital, we have treated ten newborn infants with esophageal atresia or tracheo-esophageal fistulas or both who had in addition, imperforate anus, intestinal atresia, rupture of the stomach, or pyloric stenosis. Imperforate anus was the most common anomaly. Initially, it should be treated as simply as possible. At the time of gastrostomy in infants with esophageal atresia without fistula, it is desirable to inject contrast material into the stomach and take roentgenograms at the operating table to diagnose distal obstruction. These should be corrected prior to operations on the esophageal defect in order to minimize vomiting and aspiration. A gastrostomy is essential and staging the esophageal repair is advantageous. Half of our infants were premature and three had a severe congenital cardiac lesion. There was a 60% death rate.