Muhammad Zubair, Abid Hameed Sheikh, Asif Qureshi, Zulfiqar Anjum.
Outcome of patients having esophageal atresia with tracheoesophageal fistula.
Pak Paed J Jan ;33(2):115-8.

Background: Esophageal Artesia with or without distal tracheoeso-phageal fistula is commonly seen in pediatric surgical units. Our main challenge is to manage the patients who routinely come with a delayed diagnosis and are mismanaged at primary health care level and the patients with a variable spectrum of presentation with reference to prematurity, low birth weight and associated anomalies. In this study a detailed analysis of out come of these patients is presented Materials and Method: A total number of 60 neonates with age ranging from 24 hours to 13days were included in this study. This is a single centre, prospective, descriptive study over a period of 8 years and 9 months from may 1999 to February 2008. Diagnosis was confirmed by locating contrast labeled feeding tube in upper esophageal pouch and pre and post operative management carried out. Results: There was male predominance with a male to female ratio of 3.24:1. Most of the patients were between the ages of 2-4 days (92%), most of the patients have weight between 2-3 kg (50%), commonest type of atresia was that with distal fistula (95%). Commonest associated anomalies noted were cardiac defects (13%). 85% of patients received surgical treatment, out of which 80% were started oral feed on 6th postoperative day. 9% developed anastomotic leak , 2% anastomotic disruption , 17 % had fatal post operative sepsis , 4% late anastomotic stricture and 16% had gastro esophageal reflux. Over all mortality was 37.7% Conclusion: Awareness of the problems at primary health care level and antenatal diagnosis by a trained sinologist can prevent the delay of diagnosis and referral to tertiary care center. Early and prompt management can reduce complication and overall mortality and improve out come.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com