Mind the Missing Gap: A Cervical Variant of Type A Esophageal Atresia

<b>Background:</b> Esophageal atresia (EA) type A, characterized by the absence of a tracheoesophageal fistula and typically presenting with a long esophageal gap, usually requires staged repair. <b>Methods:</b> We report a rare case of a newborn with type A EA in which both...

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Main Authors: Marco Di Mitri, Riccardo Coletta, Edoardo Collautti, Cristian Bisanti, Annalisa Di Carmine, Roberto Lo Piccolo, Elena Rovero, Francesca Tocchioni, Elisa Severi, Marco Moroni, Ioannis Georgopoulos, Dariusz Patkowski, Mario Lima
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Language:English
Published: MDPI AG 2025-06-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/6/740
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author Marco Di Mitri
Riccardo Coletta
Edoardo Collautti
Cristian Bisanti
Annalisa Di Carmine
Roberto Lo Piccolo
Elena Rovero
Francesca Tocchioni
Elisa Severi
Marco Moroni
Ioannis Georgopoulos
Dariusz Patkowski
Mario Lima
author_facet Marco Di Mitri
Riccardo Coletta
Edoardo Collautti
Cristian Bisanti
Annalisa Di Carmine
Roberto Lo Piccolo
Elena Rovero
Francesca Tocchioni
Elisa Severi
Marco Moroni
Ioannis Georgopoulos
Dariusz Patkowski
Mario Lima
author_sort Marco Di Mitri
collection DOAJ
description <b>Background:</b> Esophageal atresia (EA) type A, characterized by the absence of a tracheoesophageal fistula and typically presenting with a long esophageal gap, usually requires staged repair. <b>Methods:</b> We report a rare case of a newborn with type A EA in which both the proximal and distal esophageal pouches were unexpectedly close and located in the cervical region. This anatomical variant allowed for a successful primary anastomosis through a cervical approach. <b>Results:</b> Initial imaging was misleading, and the true anatomy was clarified only through thoracoscopic exploration, underscoring the importance of intraoperative flexibility. <b>Conclusions:</b> To our knowledge, this is the first report of such a presentation in type A EA, with significant implications for diagnosis and surgical strategy.
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institution Kabale University
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publishDate 2025-06-01
publisher MDPI AG
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series Children
spelling doaj-art-aa1ae8f8d5ff4f2d9be16fa9be0127662025-08-20T03:27:13ZengMDPI AGChildren2227-90672025-06-0112674010.3390/children12060740Mind the Missing Gap: A Cervical Variant of Type A Esophageal AtresiaMarco Di Mitri0Riccardo Coletta1Edoardo Collautti2Cristian Bisanti3Annalisa Di Carmine4Roberto Lo Piccolo5Elena Rovero6Francesca Tocchioni7Elisa Severi8Marco Moroni9Ioannis Georgopoulos10Dariusz Patkowski11Mario Lima12Pediatric Surgery Department, Meyer Children’s Hospital IRCCS, 50139 Firenze, ItalyPediatric Surgery Department, Meyer Children’s Hospital IRCCS, 50139 Firenze, ItalyPediatric Surgery Department, Meyer Children’s Hospital IRCCS, 50139 Firenze, ItalyPediatric Surgery Department, IRCCS Sant’Orsola, Alma Mater Studiorum, University of Bologna, 40126 Bologna, ItalyPediatric Surgery Department, IRCCS Sant’Orsola, Alma Mater Studiorum, University of Bologna, 40126 Bologna, ItalyPediatric Surgery Department, Meyer Children’s Hospital IRCCS, 50139 Firenze, ItalyPediatric Surgery Department, Meyer Children’s Hospital IRCCS, 50139 Firenze, ItalyPediatric Surgery Department, Meyer Children’s Hospital IRCCS, 50139 Firenze, ItalyPediatric Surgery Department, Meyer Children’s Hospital IRCCS, 50139 Firenze, ItalyNeonatal Intensive Care Unit, Meyer Children’s Hospital IRCCS, 50139 Firenze, ItalyDepartment of Surgery, Aghia Sophia Children’s Hospital, 115 27 Athens, GreeceDepartment of Pediatric Surgery and Urology, Wroclaw Medical University and Hospital, Borowska 213, 50-556 Wroclaw, PolandPediatric Surgery Department, IRCCS Sant’Orsola, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy<b>Background:</b> Esophageal atresia (EA) type A, characterized by the absence of a tracheoesophageal fistula and typically presenting with a long esophageal gap, usually requires staged repair. <b>Methods:</b> We report a rare case of a newborn with type A EA in which both the proximal and distal esophageal pouches were unexpectedly close and located in the cervical region. This anatomical variant allowed for a successful primary anastomosis through a cervical approach. <b>Results:</b> Initial imaging was misleading, and the true anatomy was clarified only through thoracoscopic exploration, underscoring the importance of intraoperative flexibility. <b>Conclusions:</b> To our knowledge, this is the first report of such a presentation in type A EA, with significant implications for diagnosis and surgical strategy.https://www.mdpi.com/2227-9067/12/6/740esophageal atresiatype A esophageal atresiacervical esophageal atresiaprimary anastomosislong gap esophageal atresiathoracoscopic surgery
spellingShingle Marco Di Mitri
Riccardo Coletta
Edoardo Collautti
Cristian Bisanti
Annalisa Di Carmine
Roberto Lo Piccolo
Elena Rovero
Francesca Tocchioni
Elisa Severi
Marco Moroni
Ioannis Georgopoulos
Dariusz Patkowski
Mario Lima
Mind the Missing Gap: A Cervical Variant of Type A Esophageal Atresia
Children
esophageal atresia
type A esophageal atresia
cervical esophageal atresia
primary anastomosis
long gap esophageal atresia
thoracoscopic surgery
title Mind the Missing Gap: A Cervical Variant of Type A Esophageal Atresia
title_full Mind the Missing Gap: A Cervical Variant of Type A Esophageal Atresia
title_fullStr Mind the Missing Gap: A Cervical Variant of Type A Esophageal Atresia
title_full_unstemmed Mind the Missing Gap: A Cervical Variant of Type A Esophageal Atresia
title_short Mind the Missing Gap: A Cervical Variant of Type A Esophageal Atresia
title_sort mind the missing gap a cervical variant of type a esophageal atresia
topic esophageal atresia
type A esophageal atresia
cervical esophageal atresia
primary anastomosis
long gap esophageal atresia
thoracoscopic surgery
url https://www.mdpi.com/2227-9067/12/6/740
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