Diagnosis and Treatment
How We Diagnose Esophageal Atresia
EA/TEF is diagnosed prenatally (during pregnancy) about half the time. It is often diagnosed after the baby is born:
- Prenatally: Excess amniotic fluid or a small stomach on ultrasound may signal EA/TEF.
- After Baby is Born: EA/TEF may be suspected if the baby chokes, coughs, or turns blue when attempting to feed. To diagnose EA/TEF, the baby’s physician will attempt to pass a feeding tube through the baby’s mouth or nose. X-ray imaging that shows the feeding tube coiled in the upper esophagus establishes the diagnosis of EA/TEF.
Our Approach to Care
Holistic and Comprehensive Care
We recognize that every child with EA/TEF has a unique set of symptoms, circumstances, and needs. We take a holistic approach to care that considers the entire patient, including his or her physical, emotional, and social factors. We strive to partner with patients and their parents in shared decision-making, empowering them with knowledge, support, and the most effective treatment options to achieve the best possible outcome for every child.
Multidisciplinary Team Approach to Care
Our EA care team consists of pediatric surgeons and specialists from a wide range of disciplines that collaborate to address the unique needs of each patient. Your child’s care may require the coordinated efforts of a team of specialists such as pediatric surgeons, pediatric gastroenterologists, pediatric cardiologists, speech therapists, nutritionists, intensive care specialists and nurses, and other healthcare professionals. This multidisciplinary team approach extends to ongoing management throughout the childhood years.
Newborn Specialty Care
Our pediatric surgeons collaborate with specialists at NewYork-Presbyterian’s two perinatal centers -- the NewYork-Presbyterian/Columbia University Irving Medical Center Carmen and John Thain Center for Prenatal Pediatrics and the NewYork-Presbyterian/Weill Cornell Medical Center Fetal Care Center -- to counsel and plan surgery to correct neonatal congenital abnormalities such as EA/TEF. Our team works closely with neonatologists at our two main academic campuses to care for the most fragile infants.
Continuity of Care throughout the Lifespan of the Child
At NewYork-Presbyterian, a vital aspect of our digestive disease programs is continuity of care. Children who have a lifelong need for specialized care, such as those diagnosed with EA/TEF, are embraced by our care teams. We understand the continuous needs of patients regardless of age and are vested in making certain that the transition from childhood to adulthood is simplified by not needing to change care teams. Our integrated care team seamlessly transitions patients from childhood through the teen years and early adulthood. When the time comes, we help our patients transition to NewYork-Presbyterian adult care practitioners.
How We Treat Esophageal Atresia
Treatment for EA/TEF involves surgical repair to disconnect the connection between the trachea and esophagus, often very soon (24-48 hours) after birth. At NewYork-Presbyterian, our pediatric teams include pediatric surgeons, anesthesiologists, radiologists, gastroenterologists, neonatologists, perinatologists, and other surgical subspecialists to provide comprehensive care for children with EA/TEF. When appropriate, our pediatric surgeons use a minimally invasive surgical approach for EA/TEF repair that involves three small incisions in the chest. This surgery is highly successful and patients usually do well. We have special expertise in performing primary repair of EA/TEF in premature babies with low birth weights. Surgery for these infants is often very challenging because these infants may present with a very wide gap between the two ends of the esophagus. We use the most innovative techniques for reconstruction while preserving the patient’s native esophagus.
Follow-up and Long Term Management
Although surgery for EA/TEF is highly successful, children who undergo EA/TEF surgery require long-term follow-up to address associated birth defects and monitor the health of the esophagus. Issues affecting these children include gastroesophageal reflux, motility disorders, growth, and nutritional problems, and pulmonary problems. At NewYork-Presbyterian, our multidisciplinary team of EA/TEF specialists provides comprehensive and coordinated care for the long-term management of these problems. Your child’s care may require coordinated efforts of pediatric surgeons, pediatric gastroenterologists, cardiologists, speech therapists, nutritionists, Ear, Nose, and Throat specialists, and radiologists who will work together to achieve the best outcome for your child.