The Annals of Thoracic Surgery, Vol 38, 195-200, Copyright © 1984 by The Society of Thoracic Surgeons
Esophageal atresia with double fistula: the missed anomaly
AM Johnson, BM Rodgers, B Alford, GR Minor and A Shaw
Of the various anatomical types of atresia, that of esophageal atresia and
double fistula is said to be the least common. In most series, frequency is
less than 1%. Seventy-eight patients with esophageal atresia were treated
at the University of Virginia Medical Center between 1955 and 1983. Six of
them had esophageal atresia and double fistula, and in 5 of these 6, this
anomaly was not diagnosed preoperatively and was not detected
intraoperatively. Our experience suggests that proximal "pouchograms" are
essential in the preoperative evaluation of these patients to detect the
presence of esophageal atresia and double fistula. The morbidity and
mortality occasioned by overlooking this anomaly far exceed the risk of the
contrast study.