[Atresia of the esophagus. Experience in 33 patients]. / Atresia de esófago. Experiencia en 33 pacientes.

The authors present their experience in the management of 33 patients with esophageal atresia. Twenty-six of them were type III (fistula from the lower end of the esophagus); four cases were "H" type of fistula and three cases were type one (with no fistula). In the type III group (26 patients) the major associated malformations seemed to be the most important factor that contributted to the mortality rate. Birth weight and the age at the moment of the diagnosis, did not seem to influence the final outcome. In this group, 13 patients died (50% mortality), ten patients had major associated malformations, all of them died (100% mortality). 16 patients did not have associated malformations; from them, only three died (18% mortality). All the patients with type "H" malformations survived. All the patients with type I malformations underwent gastrostomy and a cervical esophagostomy. One patient died in the immediate postoperatory period. The second one underwent a successful colon interposition and the third one was lost from control.

[Intestinal atresia]. / Atresia intestinal.

The authors reviewed their experience with 20 cases of intestinal atresia (jejunum, ileum and colon) admitted between January 1972 and January 1977. International literature shows 80% mortality rate for this malformation before 1940 and 10-25% in current reports. In Mexico, before 1959, the mortality rate was 80%, but the most recent reports showed 28% mortality rate for atresia and 33% in cases of stenosis. The group of patient studied included twelve cases with a weight over 2,500 g. and eight patients under 2,500 g. Four patients showed multiple associated malformations (incompatible with life in one case) and in 17, there were no associated malformations. Nineteen cases were operated, the dilated and atresic segments were resected and anastomosis was performed. It was termino-terminal in 13 cases and termino-lateral in 6. One case was explored surgically and no attempt to repair the atresias was made, because there were malformations incompatible with life. Four patients died. Even if this series is very small, the associated malformations, low weight and techniques used do not seem to influence the prognosis of these patients.