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Oesophageal Atresia 309

Key Summary Points
1. The incidence of oesophageal atresia in Africa is comparable 4. Diagnosis of PA is confirmed with a nasogastric tube and high
to that in the Western world. index of suspicion.
2. Prenatal diagnosis of OA is rare. 5. A babygram is the most useful image.
3. Delayed presentation of OA with pneumonia, dehydration, and 6. Outcomes depend on the availability of resources and
failure to feed is the norm in Africa. technical skill.

Suggested Reading

Bar-Maor JA, Shoshany G, Sweed Y. Wide gap esophageal atresia: Holcomb GW, Rothenberg SS, Bax K, et al. Thoracoscopic repair
a new method to elongate the upper pouch. J Pediatr Surg 1989; of esophageal atresia and tracheoesophageal fistula: a multi-
24(9):882–883. institutional analysis. Ann Surg 2005; 242(3):428–430.
Da Carvalho JL, Maynard J, Hadley GB. An improved technique for Iliff PJ. Neonatal surgery in Harare Hospital. Cent Afr Jour Med 1990;
in situ esophageal myotomy and proximal pouch mobilization in 36(1):11–15.
patients with esophageal atresia. J Pediatr Surg 1989; 24(9):872–
873. Lugo B, et al. Thoracoscopic versus open repair of
tracheoesophageal fistula and esophageal atresia. J
Davies MRQ. Anatomy of the extrinsic motor nerve supply to Laperoendosc Adv Surg Tech 2008; 18(5):753–756.
mobilized segments of the oesophagus disrupted by dissection Nandi B, Mungongo C, Lakhoo, K. A comparison of neonatal surgical
during repair of oesophageal atresia with distal fistula. Brit J Surg admissions between two linked surgical departments in Africa and
1996; 83:1268–1270.
Europe. Pediatr Surg Int 2008; 24:939–942.
Goyal A, Jones MO, Couriel JM, Losty PD. Oesophageal atresia
and tracheo-oesophageal fistula. Review. Arch Dis Child Fetal Puri P, Khurana S. Delayed primary esophageal anastomosis for pure
Neonatal Ed 2006; 91(5):F381–F384. esophageal atresias. Semin Pediatr Surg 1998; 7(2):126–129.