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.