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  • Letter to the Editor
  • Open Access

Respiratory and gastrointestinal symptoms in esophageal atresia

Italian Journal of Pediatrics200834:5

  • Received: 11 October 2008
  • Accepted: 08 December 2008
  • Published:


  • Child Health
  • Lung Function
  • Respiratory Disease
  • Respiratory Symptom
  • Gastrointestinal Symptom


Mastroianni et al. [1] report high prevalence (100%) of respiratory symptoms in their cohort of 19 children who received surgery for esophageal atresia. In contrast with the results of other studies [2], they found gastro-esophageal reflux incidence was low (26,3%). They therefore emphasize anti-reflux therapy could not be effective for treatment of respiratory symptoms in this group of patients.

We agree with the speculation of the authors, as this was also our experience. Indeed, children who received surgical intervention for esophageal atresia have high incidence of respiratory function abnormalities [3] and bronchial hyperreactivity [4]. These conditions may be multifactorial in origin and are related to recurrent inhalation, epithelial damage, bronchial obstruction and tracheomalacia.

Treatment of underlying respiratory disease instead of anti-reflux therapy may be warranted in children with a history of surgical repair of esophageal atresia and tracheoesophageal fistula, especially when lung function studies confirm respiratory involvement.

Authors’ Affiliations

Division of Pediatrics, AziendaOspealiero-Universitaria "Ospedali Riuniti", Ancona, Italy
Division of Pediatric Surgery, AziendaOspealiero-Universitaria "Ospedali Riuniti", Ancona, Italy


  1. Mastroianni R, Quaglietta L, Simeone D, Miele E, Capobianco A, Tramontano A, Staiano A: Respiratory symptoms and esophageal function after operation for esophageal atresia. Ital J Pediatr. 2007, 33: 330-335.Google Scholar
  2. Kovesi T, Rubin S: Long term complications of congenital esophageal atresia and tracheoesophageal fistula. Chest. 2004, 126: 915-925. 10.1378/chest.126.3.915.View ArticlePubMedGoogle Scholar
  3. Agrawal L, Beardsmore CS, MecFabien UM: Respiratory function in childhood following repair of oesophageal atresia and tracheoesophageal fistula. Arch Dis Child. 1989, 81 (5): 404-408.View ArticleGoogle Scholar
  4. Milligan DWA, Levison H: Lung function in children following repair of tracheoesophageal fistula. J Pediatr. 1979, 95: 24-27. 10.1016/S0022-3476(79)80076-1.View ArticlePubMedGoogle Scholar


© de Benedictis and Martino; licensee BioMed Central Ltd. 2008

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.