Esophageal atresia: gastroesophageal functional follow-up in 5-15 year old children

J Pediatr Surg. 2013 Dec;48(12):2487-95. doi: 10.1016/j.jpedsurg.2013.07.019.


Purpose: Esophageal atresia (EA) is one of the most frequent congenital alimentary tract anomalies with a considerable morbidity throughout childhood. This study evaluates the gastroesophageal problems in 5-15 year old children with EA and aims to identify factors predisposing to esophagitis in EA.

Material and methods: Fifty-nine patients primarily operated at Odense University Hospital, Denmark, during 1993-2005 were included in this follow-up study. The patients underwent the following examinations: Interview, upper endoscopy, endoscopic ultrasonography, high-resolution esophageal manometry (HREM), and pH- and multichannel intraluminal impedance (MII) measurements. Twenty-five patients with suspected gastro-esophageal reflux disease (GERD) underwent the same investigations and served as controls.

Results: Median age was 10.2 years (7.1-13.3). Thirty-three (55.9%) presented with GERD symptoms, 41 (69.5%) with dysphagia, and 33 (55.9%) with respiratory symptoms. Twenty-nine (49.2%) had endoscopic esophagitis, and 26 (44.1%) histological esophagitis. Median reflux index (RI) was 8.3 (4.8-14.9). In 32 (55.2%) RI was above 7. Ten percent had eosinophilic inflammation. HREM showed dysmotility in the esophagus in all EA patients, 83.3% had no propagating swallows. No predictive factors predisposing the development of endoscopic esophagitis were identified.

Conclusions: Gastroesophageal problems in children born with EA are common. Routine follow-up with endoscopy and pH-metry in EA patients is warranted.

Keywords: Children; Esophageal atresia; Esophageal motility disorders; Gastroesophageal reflux disease; High resolution esophageal manometry; Upper endoscopy.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Deglutition Disorders / diagnosis
  • Deglutition Disorders / epidemiology
  • Deglutition Disorders / etiology*
  • Endosonography
  • Esophageal Atresia / surgery*
  • Esophageal Motility Disorders / diagnosis
  • Esophageal Motility Disorders / epidemiology
  • Esophageal Motility Disorders / etiology*
  • Esophageal pH Monitoring
  • Esophagitis / diagnosis
  • Esophagitis / epidemiology
  • Esophagitis / etiology*
  • Esophagoscopy
  • Female
  • Follow-Up Studies
  • Gastroesophageal Reflux / diagnosis
  • Gastroesophageal Reflux / epidemiology
  • Gastroesophageal Reflux / etiology*
  • Humans
  • Logistic Models
  • Male
  • Manometry
  • Multivariate Analysis
  • Plethysmography, Impedance
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / epidemiology
  • Prospective Studies