Pressure-Induced Growth (PIG) of Atretic Esophagus: A Contigent Management for High-Risk Esophageal Atresia

The management of uncomplicated esophageal atresia is a straightforward procedure consisting of thoracotomy with anastomosis of the atretic segments and ligature of any tracheoesophageal fistula present. However, besides the rareness of isolated esophageal atresia, our observations in the past few years show increasing incidence of the anomaly in association with premature births and other malformations which are usually incompatible with life. Aspiration pneumonia resulting from reflux of gastric content through a lower tracheoesophageal fistula, rather than the overflow of saliva from an upper atretic pouch, also threatens the life of an otherwise healthy neonate with esophageal atresia.