Korean J Gastrointest Motil.  2001 Jun;7(1):21-28.

Motor Dysfunction of the Esophagus after Repair of Esophageal Atresia and Tracheoesophageal Fistula

• Kim JY
• Choe BH
• Ko JS
• Park KW
• Seo JK

Abstract

BACKGROUND/AIMS: The aim of this study was to characterize the spectrum of esophageal motor dysfunction after repair of an esophageal atresia with a tracheoesophageal fistula (EATEF).
METHODS
This study included 16 patients, aged 0.8 to 13.3 years, who were diagnosed with Gross Type C esophageal atresia and underwent a fistula repair and end to end anastomosis. Esophageal function was evaluated with manometry, 24 hour esophageal pH monitoring, a barium esophagogram, and an endoscopy.
RESULTS
Symptoms were present in 8 patients (dysphagia for solid food in 2; frequent vomiting in 6; and poor weight gain in 4). Anastomotic stricture was present in 6 patients. An esophageal manometric study showed that the reflex relaxation of the lower esophageal sphincter (LES) was incomplete or absent in 9 patients (56%). The upper esophageal sphincter (UES) was completely relaxed in all 16 patients. In 14 patients (88%), a normal peristaltic wave was present in the proximal esophagus, but absent below the anastomotic site. Simultaneous contractions were observed in 2 patients (12%). Seven (64%) of 11 patients who underwent 24 hour esophageal pH monitoring presented gastroesophageal reflux.
CONCLUSION
Most of the patients after the repair of an EATEF developed motor dysfunction of the esophagus. Poor transmission of the peristaltic waves beyond the anastomotic site and abnormal reflex relaxation of the LES were present.

Keyword

Esophageal atresia; Tracheoesophageal fistula; Esophageal manometry; Esophageal motor dysfunction

MeSH Terms

Barium
Constriction, Pathologic
Endoscopy
Esophageal Atresia*
Esophageal pH Monitoring
Esophageal Sphincter, Lower
Esophageal Sphincter, Upper
Esophagus*
Fistula
Gastroesophageal Reflux
Humans
Manometry
Reflex
Reflex, Abnormal
Relaxation
Tracheoesophageal Fistula*
Vomiting
Weight Gain
Barium