Esophageal atresia: Primary repair of a rare long gap variant involving distal pouch mobilization

This report describes a rare type IIIb variant of long gap pure esophageal atresia treated with delayed primary repair. Preoperative imaging showed a distal pouch with a unusually long tapering end, and a 5-vertebral body gap . Delayed exploration with mobilization of the distal pouch allowed for suc cessful primary repair without the need of myotomy. The characteristic radi ological appearance of this rare variant enables its preoperative recogniti on and warrants attempting primary repair with a good expectation of succes s. J Pediatr Surg 34:1881-1883. Copyright (C) 1999 by W.B. Saunders Company .