A histopathological study of esophageal atresia and tracheoesophageal fistula

Background/Purpose: Histopathologic examination of the esophagus has not be en reported often in esophageal atresia (EA) and tracheoesophageal fistula (TEF). Abnormal esophageal motility has been reported after successful repa ir of EA and TEF, although the exact etiology of this motility disorder rem ains unclear. Histological evaluation of the fistulous portion of the esoph agus has been performed to document any abnormality that may be responsible for the abnormal motility. Methods: Histopathological study of fistulous segment of esophageal atresia and distal TEF was conducted on 65 patients, which included autopsy materi al from 3 patients in whom the entire esophagus was examined by serial sect ion. Special stains were administered to each specimen to look for tracheob ronchial remnants and the arrangement of muscle fibers. Clinical evaluation was performed in 27 patients who were available for review 6 months to 9 y ears after successful surgical treatment. These patients were categorized i nto 3 groups according to their clinical status. Results: These findings showed that the majority of these patients have tra cheobronchial remnants in the esophagus in the form of abnormal mucous glan ds and ducts, abnormal mucin secretion, presence of cartilage, and a disorg anized muscle coat. Conclusions: The presence of abnormal mucous glands and abnormal mucin secr etion has not been highlighted before. Although tracheobronchial remnants a nd a disorganized muscle coat are common findings in the fistulous portion of the esophagus, these may not reflect the structure of the remaining esop hagus, Copyright (C) 2000 by W.B. Saunders Company.