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Question 5#

The most common form of esophageal atresia (EA) is:

a. Pure EA (no fistula)
b. Pure TEF (no atresia)
c. EA with distal tracheoesophageal fistula
d. EA with proximal tracheoesophageal fistula

Correct Answer is C

Comment:

The five major varieties of esophageal atresia (EA) and tracheoesophageal fistula (TEF) are shown in Fig. below. The most commonly seen variety is EA with distal TEF (type C), which occurs in approximately 85% of the cases in most series. The next most frequent type is pure EA (type A), occurring in 8 to 10% of patients, followed by TEF without EA (type E). This occurs in 8% of cases and is also referred to as an H-type fistula, based on the anatomic similarity to that letter (Fig. below). EA with fistula between both proximal and distal ends of the esophagus and trachea (type D) is seen in approximately 2% of cases, and type B, EA with TEF between proximal esophagus and trachea, is seen in approximately 1% of all cases.

 

The five varieties of esophageal atresia and tracheoesophageal fistula. A. Isolated esophageal atresia. B. Esophageal atresia with tracheoesophageal fistula between proximal segment of esophagus and trachea. C. Esophageal atresia with tracheoesophageal fistula between dista l esophag us and trachea. D. Esophageal atresia with fistula between both proximal and distal ends of esophagus and trachea. E. Tracheoesophageal fistula without esophageal atresia (H-type fistula). 

Barium esophagram showing H-type tracheoesophageal fistula (arrow).