¹ SONOSCAN, Ultrasonic Scan Centre, 16B, Venkatachalam Road, R.S.Puram^{; 2} Consultant Obstetrician, Nalini Hospital,Thirupur

Prevalence: esophageal atresia occurs 3.3:10,000 births. Esophageal atresia with distal TEF is the most common form (87%), isolated esophageal atresia (8%) and isolated TEF (5%).

Case report:

25-year-old woman GII PI was referred for sonography to rule out fetal anomalies, because of hydramnios. She has one live female child of 4 years. There is no history of consanguinity. The period of gestation by LMP was 34 weeks. Fetal biometry corresponded to 34 weeks. There was polyhydramnios.

Figure 1 shows normal stomach bubble of good size.

Figure 2 shows a coronal scan fetal neck, showing fluid filled blind ending esophageal pouch.

Figure 3- similar section after a while shows emptying of the pouch.

The features are diagnostic of esophageal atresia with TEF. The patient went into preterm labor 10 days after the scan. A feeding tube passed returned back confirming esophageal atresia. The x-ray showed air in the stomach confirming TEF. The child developed respiratory distress and died in half an hour. Parents declined autopsy.

Associated anomalies: other malformations-gastrointestinal (21%), cardiovascular (20%), urogenital (10%) and skeletal (20&). It may be part of VATER association. 7% will have aneuploidy.

Prognosis: good

Recurrence risk: Not known.

References:

S.Boopathy Vijayaraghavan: Antenatal Diagnosis of Esophageal Atresia with Tracheoesophageal Fistula. J Ultrasound Med 15:417-419,1996

G.Centinit, L.Rosignoli, A.Kenanidis & F.Petraglia: Prenatal diagnosis of esophageal atresia with the pouch sign. Ultrasound Obstet Gynecol 21: 494-497,2003.

.