What is Atresia?

An atresia is a congenital condition, also known as a birth defect, where a body cavity or passage is deficient or abnormally closed. Normally affecting organs of the digestive and cardiovascular systems, an atresia is a treatable condition which can require surgery. If left untreated, most atresias are fatal.

An esophageal atresia, also referred to as a tracheoesophageal fistula, occurs when the esophagus does not properly develop. In the case of an atresia, the upper portion of the esophagus is closed, blocking the entrance of food to the digestive system. A diagnosis of esophageal obstruction is made shortly after birth when feedings are attempted and the skin of the infant adopts a bluish hue, called cyanosis. The infant may also cough, drool, and choke when attempted feedings occur.

The presence of an esophageal closure is considered a medical emergency and surgery is scheduled as soon as the infant is stable. Prior to surgery it is essential that precautions are taken to ensure the child does not inhale, or breathe, secretions into his or her lungs. Prognosis associated with esophageal closure is good as long as the condition is caught early. Complications associated with this condition include aspiration pneumonia, choking, and postoperative reflux.

A duodenal atresia is a closure or absence of the opening of the first section of small intestine connecting it to the stomach and, if left untreated, can be deadly. Associated with Down syndrome, a duodenal obstruction is also related to instances of polyhydramnios, which is an accumulation of amniotic fluid within the amniotic sac during pregnancy. A diagnosis of this form of atresia is generally confirmed through an x-ray which shows the entrapment of air in the stomach and duodenum, or a portion of the small intestine. There is no documented cause for the development of duodenal closure, though it is speculated that its origin stems from issues during embryonic development.

Symptoms of duodenal obstruction include the absence of urination or bowel movements, abdominal swelling, and vomiting of large volumes that contain bile, or stomach acids. Treatment for duodenal atresia includes intravenous administration of supplements, and the introduction of a tube into the stomach to aid with decompression. The option of surgery is dependent upon the nature of the abnormality and may not be considered an immediate necessity. If surgery is conducted, postoperative complications include acid reflux and some duodenal swelling, also known as megaduodenum.

Though rare, atresias can affect the tricuspid or pulmonary heart valves. Both abnormalities obstruct blood flow and impede the heart's ability to support the body's organs. Symptoms associated with these types of atresia include cyanosis, breathing difficulty, and persistent fatigue. Treatment always requires surgery which can involve valve repair or replacement or, in severe cases, heart transplant. Improvement is expected with surgery; however, complications including stroke and heart failure are possible.