title: Postoperative appearances of esophageal atresia repair: retrospective study of 210 patients with review of literature - what the radiologist should know.
abstract: BACKGROUND
  Primary surgical repair forms the definitive treatment of esophageal atresia. Long-term survival rates and patient morbidity after repair still remains a problem especially in developing countries. Postoperative morbidity depends on the incidence of anastomotic leak, gastroesophageal reflux, strictures, and recurrent fistula formation.
  
  
  OBJECTIVE
  To describe the frequency of different findings at fluoroscopic evaluation of postoperative esophagus in children following repair for esophageal atresia with or without tracheo-esophageal fistula.
  
  
  METHODS
  Hospital records and upper gastrointestinal contrast studies of 210 patients following repair for esophageal atresia with or without a tracheo-esophageal fistula were reviewed by two pediatric radiologists. All children underwent surgery in the first few days of life (days 1-6). Fluoroscopic contrast study was performed at various intervals after surgery in children with suspected complications or feeding difficulties.
  
  
  RESULTS
  Images from upper gastrointestinal contrast studies of 210 patients (126 boys, 84 girls) were evaluated and recorded. Findings were recorded as normal postoperative appearances (37.1%) and complications/sequelae, which included strictures (33.8%), minor and major leaks (11.9%), reflux (13.8%), motility problems (7.1%), persistent fistula (3.8%), diverticulae formation (4.7%), and hiatus hernia (2.1%).
  
  
  CONCLUSIONS
  Strictures, leaks, and reflux are the most common complications of esophageal atresia repair. Knowledge of various postoperative appearances would be useful for planning an appropriate management strategy in these children.
authors.affiliation: Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh, India. sodhiks@gmail.com
authors.forename: Kushaljit Singh
authors.initials: KS
authors.lastname: Sodhi
authors.forename: Akshay Kumar
authors.initials: AK
authors.lastname: Saxena
authors.forename: Chirag Kamal
authors.initials: CK
authors.lastname: Ahuja
authors.forename: Kln
authors.initials: K
authors.lastname: Rao
authors.forename: Prema
authors.initials: P
authors.lastname: Menon
authors.forename: Niranjan
authors.initials: N
authors.lastname: Kandelwal
mesh_terms: D057868:Anastomotic Leak / Q000000981:diagnostic imaging / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D004933:Esophageal Atresia / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging / Q000209:etiology; D004947:Esophagus / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005471:Fluoroscopy; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D014138:Tracheoesophageal Fistula / Q000150:complications
chemical_list: D003287:Contrast Media