Primary anastomosis in esophageal atresia type I without a gap

This paper reports the case of an infant born with type I esophageal atresi a (EA) associated with duodenal atresia (DA). The critical condition of the patient necessitated an exploratory laparotomy, which revealed severe dila tation of the stomach and duodenum. The routine procedure for repairing typ e I EA is a delayed primary anastomosis after 10 weeks of age because of th e long gap between the two esophageal segments. In our case, due to the con comitant DA, the lower pouch was long enough to allow primary neonatal anas tomosis. A radiograph taken with a Hegar dilator in the lower segment via t he gastrostomy confirmed this suspicion, and the baby underwent a thoracoto my and primary anastomosis between the esophageal pouches. The authors prop ose the possibility of primary esophageal anastomosis in similar cases.