Background: Post surgical complications of ESOPHAGEAL ATRESIA (EA) include anastomotic leak, anastomotic stricture, gastroESOPHAGEAL reflux, tracheomalacia, and recurrent tracheoESOPHAGEAL fistula (TEF). However, hypertrophic pyloric stenosis (HPS) is complicating EA which seems to be rare. The aim of this report is to emphasize on HPS as a possible complicating post operative course of EA, the diagnosis of this complicating disorder may be delayed.Case presentation: A 3000 gram male infant was born at 38 weeks gestation to a 21-year-old, gravid mother by cesarean section. He presented vomiting with profuse foamy discharge and salivation. ESOPHAGEAL ATRESIA was confirmed by looped orogastric tube in the upper pouch of esophagus in chest X-ray. He underwent surgical correction and was discharged with a good condition on 7th post operation day. Nevertheless three weeks later, he developed recurrent vomiting. The diagnosis of HPS was confirmed by ultrasonography and barium upper gastrointestinal (GI) series. Pyloromyotomy was done on him and He was discharged without any complication. At 3.5 months old, he developed regurgitation and chocking cyanosis. At this time ESOPHAGEAL stenosis was diagnosed by barium swallow. The stricture was treated by gastroduodenoscopy.Conclusion: Infantile HPS should be considered in any case of persistent vomiting and feeding intolerance after surgery for ESOPHAGEAL ATRESIA. A high index of suspicion is required for diagnosis to avoid complication arising from a delayed diagnosis.

Introduction: ESOPHAGEAL ATRESIA (EA) is a relatively common congenital anomaly. Following the increase in the survival rate of neonates with appropriate surgical procedures, timely diagnosis and treatment of surgical complications are essential. Materials and Methods: After getting ethical approval, all the patients who underwent surgery for EA at Tabriz Children's Hospital were contacted, and in case of any long-term complications, parents were invited to visit the hospital. Results: Fifty-five children, including 31 boys and 24 girls, with a mean birth weight of 2734. 63±566. 21 grams and an APGAR score of 8. 75±0. 96, participated in this study. The most common type of EA was type C (87. 3%). Respiratory disorders (47. 3%) and marked anastomotic stenosis (21. 8%) are the most common complications following surgery. Anastomotic stenosis was associated with suture tension, tracheal intubation >5 days, and birth weight<2, 500 grams. Conclusion: In the postoperative phase of EA surgery, respiratory disorders are a common complication. Anastomotic stenosis is the second most common complication. It is associated with suture tension, tracheal intubation for more than five days, birth weight less than 2, 500 grams, GastroESOPHAGEAL reflux into the esophagus, and leakage from anastomosis. There is a need for future multi-center studies to provide more reliable evidence

Introduction: ESOPHAGEAL ATRESIA (EA) with or without tracheoESOPHAGEAL fistula is a congenital malformation characterized by the interruption or obstruction of the esophagus. Neonates affected by EA may present with cyanosis during breastfeeding, sialorrhea, coughing, and respiratory difficulty. EA requires surgical treatment; otherwise, the condition could become life-threatening. Data is scarce regarding the long-term nutritional problems of children with EA. The present study aimed to assess the growth status and nutritional difficulties in children with EA. Methods: This retrospective study was conducted on 32 children with EA during 2007-2016. The nutritional status and feeding problems of the patients were assessed using a questionnaire. Results: The most common EA-associated complications were ESOPHAGEAL stricture (84. 4%), dysphagia (46. 9%), gastroESOPHAGEAL reflux disease (37. 5%), and respiratory infections (25%). The majority of the patients had normal growth parameters, and 96. 9% experienced at least one complication or feeding problem associated with EA, including the need to drink water to swallow food (25%), coughing while feeding (34. 4%), vomiting (12. 5%), and abdominal pain (34. 4%). However, no significant associations were observed between feeding problems and growth parameters. Conclusion: Feeding problems are relatively common in children with EA. Therefore, nutritional consultations must be provided to these patients in order to prevent and mitigate these problems.

ESOPHAGEAL ATRESIA (EA) is a rare congenital anomaly that may be isolated or associated with other anomalies requiring prompt medical and surgical planning for optimal result. This study was conducted to show our recent experience on the outcome of treated patients in two hospitals affiliated to Tehran University of Medical Sciences (TUMS). From January 2008 to May 2013 records of 43 neonates patients (23 male) with EA admitted in 2 children centers and all related data including demographic, diagnostic associated anomalies, surgical approaches, birth weight, mortality, and complications were collected. Inability of feeding and swallowing was the most common symptoms (in 90, 6%), associated CHD (44%), and Type C (EA) was the most common type of EA observed in 86% patients, The mortality rate was 4. 7% and most common complication was anastomotic stricture (AS) in 60% of patients. Our study showed that despite improvements in management and survival of an infant with (EA), still sepsis, aspiration pneumonia, prematurity, and low birth weight and severe Congenital Heart Disease (CHD) were independent etiology of death and birth weight < 2. 500 gr has a significant effect on the occurrence of postoperative complications.

Background: VACTERL association is a congenital abnormality involving several organs. The percentage of involvement of different organs in this illness varies and treatment success depends on the intensity of the accompanied anomalies. This study aimed to investigate the prevalence of VACTERL association in neonates Hospitalized in Be'sat Hospital in Hamadan, Iran. Materials and Methods: This retrospective study was conducted using the descriptive-analytic method and all the neonates who were hospitalized with ESOPHAGEAL ATRESIA and imperforate anus abnormalities in Be'sat Hospital, Hamadan, Iran, from April 2009 to April 2018 were included in the study. Information on the neonates were extracted from the medical records and after being recorded in the checklist, they were analyzed using SPSS v. 16 at a 95% confidence level. Results: 127 neonates were included in this study. 42 neonates (33. 1%) had ESOPHAGEAL ATRESIA, 78 (61. 4%) had imperforate anus, and 7 neonates (5. 5%) had both anomalies. 87 of these neonates (68. 5%) suffered from congenital heart disease. Atrial septal defect (31%), simultaneous presence of atrial septal defect and patent ductus arteriosus (24%), and patent ductus arteriosus (23%) were the most common congenital heart diseases, respectively. 32 neonates (25. 2%) had VACTERL association. Heart, genitourinary, and spinal anomalies were present in 93. 2%, 84. 3%, and 9. 3% of the neonates, respectively. VACTERL association was significantly observed in neonates with imperforate anus (P = 0. 001) Conclusion: VACTERL association is common in neonates who suffer from ESOPHAGEAL ATRESIA or imperforate anus. Considering the high prevalence of anomaly of other organs, in addition to complete physical examination, echocardiography, abdominal ultrasound, and radiography of the spine are recommended.

Background The ESOPHAGEAL ATRESIA (EA) is the most common ESOPHAGEAL congenital anomaly. The aim of this study was to evaluate the predictive factors in the survival of newborns with ESOPHAGEAL ATRESIA. Materials and Methods This was a descriptive-analytic cross-sectional study performed on newborns with ESOPHAGEAL ATRESIA who were admitted at Bahrami children’ s hospital, Tehran-Iran, during 7 years (2009-2015). The patient’ s information was collected from their medical records and recorded in a checklist. The variables of the checklist included: age, sex, gestational age, birth weight, congenital anomalies, duration of mechanical ventilation, duration of hospitalization, respiratory distress syndrome (RDS), and age at surgery, complications, and cause of death. Then, the relationship between different variables was evaluated with mortality and morbidity and the factors that had the greatest impact on patients' prognosis were identified. Results: The study included 95 neonates with EA. Fifty-three (55. 8%) were male. The most common anomalies were cardiac (38. 9%), renal (15. 8%), and skeletal (9. 5%). The most common postoperative complication was pneumothorax (31. 6%), pneumonia (25%), and stenosis at the site of anastomosis (21. 1%). In this study, 15 children died (mortality rate 15. 7%), and the most common cause was sepsis. There was a significant relationship between birth weight and death, pneumothorax (P=0. 008, and P=0. 037, respectively). There was no significant relationship between gestational age and mortality (P>0. 05). There was a significant relationship between major cardiac anomalies and duration of mechanical ventilation and mortality (P= 0. 043, and P<0. 001, respectively). Conclusion This study showed that neonates with ESOPHAGEAL ATRESIA, low birth weight, major cardiac anomalies and the need for prolonged mechanical ventilation are poor prognosis predictor factors.

ESOPHAGEAL ATRESIA is often associated with other anomalies. Hereditary and environmental factors may influence the incidence of associated anomalies, particularly of the urogenital system. We had 63 neonates with ESOPHAGEAL ATRESIA admitted to 2 centers in Hamadan, Iran, from 2002 to 2008. They were 38 girls (60.3%) and 25 boy (39.7%). TracheoESOPHAGEAL fistula was present in 54 neonates (85.7%), and other associated anomalies in 10 (15.9%). Cardiac anomalies were found in 7 neonates; anorectal anomalies, in 4; urinary tract anomalies, in 2; and limb anomaly, in 1. Urinary tract anomalies (3.2%) were bilateral polycystic kidney in 1 neonate and unilateral hydronephrosis due to ureteropelvic junction obstruction in another. Both neonates with urinary tract anomalies were female and both had tracheoESOPHAGEAL fistula, as well. Many of the associated congenital abnormalities influence the management protocol of ESOPHAGEAL ATRESIA, and therefore, should be detected as soon as possible after birth.

Introduction & Objective: ESOPHAGEAL ATRESIA is a type of congenital anomaly in the gastrointestinal tract in which the esophagus does not develop during the fetal period and the ESOPHAGEAL to the gastric junction is blocked in the middle of the way and is placed like a balloon hanging behind the trachea and contains various types of anatomical defects. Congenital is rooted in fetal underdevelopment in the esophagus. ESOPHAGEAL ATRESIA is a congenital disease that is treated by surgery. Early complications may occur during the first days after surgery. Materials & Methods: From 2003 to 2017, 70 patients with ESOPHAGEAL ATRESIA underwent surgery at Bahrami Children's Hospital. Early complications escaped after surgery at the NICU and in the ward under evaluation. The mean age at surgery was 3. 55 ±,2. 4 days. The mean hospital stay was 12/5±, 3/4 and short-term complications were observed in 10 cases (14. 2%). Results: Based on the results, 10 patients (14. 2%) were observed in a total of 13 complications. The most common short-term complications in these patients were respiratory failure (5 cases), aspiration pneumonia (4 cases) and anastomotic leakage (4 cases). Another complication of the study was mediastinitis, which was not reported in any of the patients. Conclusions: In the present study, which introduces the tubeless method, access to the operation site is extrapleural. The azygous vein is preserved and at the end of the operation chest tube and NGT are not used. Therefore, early postoperative complication and morbility are less and this method can be used. Suggested in the repair of ESOPHAGEAL ATRESIA type c.