title: 13 pairs of ribs--a predictor of long gap atresia in tracheoesophageal fistula.
abstract: Results of treatment of tracheoesophageal fistula (TEF) have improved over the years. However, long gap atresias continue to be a problem and require modification in the conventional operation. Preoperative diagnosis of a long gap atresia in a case of TEF is difficult, and often the defect is noted only at thoracotomy, thus necessitating multiple intraoperative changes in the position of the neonate. In the past 5 years the authors have treated 61 cases of TEF. Of these, 12 had a long gap atresia. Nine of these 12 patients had 13 pairs of ribs. None of the patients with a short gap atresia had 13 pairs of ribs. Hence, the presence of 13 pairs of ribs is a good indicator of long gap atresia. In a child who has TEF with 13 pairs of ribs, suitable modifications in operative procedure can be planned. The report also discusses the possible embryological basis of this association.
authors.affiliation: Department of Paediatric Surgery, L.T.M.G. Hospital, Sion, Mumbai, India.
authors.forename: B
authors.initials: B
authors.lastname: Kulkarni
authors.forename: R S
authors.initials: RS
authors.lastname: Rao
authors.forename: S
authors.initials: S
authors.lastname: Oak
authors.forename: M A
authors.initials: MA
authors.lastname: Upadhyaya
mesh_terms: D004933:Esophageal Atresia / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D004946:Esophagostomy; D005774:Gastrostomy; D006801:Humans; D007231:Infant, Newborn; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D012272:Ribs / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014138:Tracheoesophageal Fistula / Q000150:complications* / Q000175:diagnosis / Q000601:surgery