Atresia

What is Atresia?

Atresia affects the digestive tract, which runs from the mouth through the esophagus, stomach, and intestines to the rectum and anus. This group of conditions is congenital, or present at birth. Atresia causes blockages in various parts of the digestive tract and prevents nutrients from flowing properly through baby’s system.

Atresia occurs when parts of the digestive tract don’t develop properly in the womb. Some sections are narrowed, and others are missing. Atresia can develop in the esophagus or in various sections of the intestines, including:

Duodenum, the upper part of the small intestine that connects to the stomach
Jejunum, middle part of the small intestine
Ileum, end of the small intestine
Colon, the large intestine

(Illustration of Duodenal Atresia)

The esophagus carries food and liquids from the mouth to the stomach. In most types of esophageal atresia, the upper esophagus ends and doesn’t connect with the lower esophagus. In some cases, the esophagus is narrowed. Many babies with esophageal atresia also have a tracheoesophageal fistula, an abnormal connection from the esophagus to the trachea (windpipe).

Types of Atresia include:

Esophageal Atresia

Esophageal atresia is a congenital condition in which the esophagus—the tube that carries food from the mouth to the stomach—does not form properly. Instead of being a continuous passage, it ends in a blind pouch and does not connect to the stomach. In many cases, esophageal atresia is also associated with a tracheoesophageal fistula (TEF), an abnormal connection between the esophagus and the windpipe (trachea).

Duodenal Atresia

In duodenal atresia, the duodenum (upper part of small intestine) is narrowed or missing a segment. Duodenal atresia often occurs in babies with Down syndrome, a genetic disorder involving an extra copy of a chromosome. Dr. Mehra works closely with the Down Syndrome Clinic at Advocate Children’s Hospital to provide comprehensive care for parents of children with this diagnosis.

Intestinal Atresia

Intestinal atresia is a congenital condition in which part of the intestine is narrowed or completely blocked, preventing the normal passage of food and fluid. This condition typically develops during fetal growth and can affect any part of the intestine, most commonly the small intestine.

What causes Atresia?

The causes of atresia are unknown. Research suggests that risk factors may include genetic changes or certain medications taken during pregnancy.

What are the signs of Atresia?

A routine ultrasound can show some signs of atresia during pregnancy, and other signs occur after a baby is born. Signs that can appear during prenatal ultrasounds include:

Distended (bloated) intestine
Distended stomach (with duodenal atresia)
Too much amniotic fluid (protective fluid surrounding the baby in the womb)

How is Atresia diagnosed?

If your doctor suspects atresia based on a routine ultrasound, more advanced imaging may be needed to confirm the diagnosis. The imaging we may use includes:

Targeted, high-resolution ultrasound
Ultrafast fetal MRI
X-ray

Dr. Mehra may also recommend a genetic consultation and evaluation. Working together, Dr. Mehra and his team gather as much information as possible to develop a comprehensive plan of care for prenatal, birth, post pardum and neonatal care. Click the link to learn more about how we diagnose fetal conditions.

Evaluation for Related Conditions

Some children with atresia may also have problems with their heart, and those with duodenal atresia may have Down syndrome. We partner with the Heart Institute and the Down Syndrome Clinic at Advocate Children’s Hospital to offer each family exceptional, comprehensive care.

Additional tests for these children may include:

How is Atresia managed before birth?

During pregnancy, mother and baby are closely monitored for indications that could lead to premature birth, such as a buildup of amniotic fluid. This buildup enlarges the uterus and creates pressure, which can lead to preterm labor. If necessary, we may perform an amnioreduction, which uses a small needle inserted through the abdomen to remove excess fluid and relieve pressure.

How is Atresia managed after birth?

The Neonatology and Pediatric Surgery teams evaluate your baby after birth. They will determine next steps in care, which may include surgery to repair the atresia or blockages. Dr. Mehra and his staff help each family establish care with other specialsits when indicated, making for a smooth transition of care once baby is born.

Learning that your baby has atresia is troubling; however, Dr. Mehra and his team are here to make sure that your baby stays safe in the womb, while planning any necessary care after delivery.