Overview
Atresia refers to the absence or abnormal closure of a body opening or tubular structure, often present at birth. It can affect various organs, including the esophagus, anus, bile ducts, or small intestines. In Korea, early diagnosis and advanced surgical options provide high success rates for treating different forms of atresia, especially in infants and newborns.
What is Atresia?
Atresia is a congenital condition where a normal body passage or tube is absent, narrowed, or completely blocked. Depending on the organ affected, it may cause severe complications in feeding, digestion, breathing, or elimination. Common types include esophageal atresia, biliary atresia, anal atresia, and pulmonary atresia.
Symptoms
Symptoms depend on the type and severity of the atresia, but may include:
- Esophageal atresia: Drooling, choking, coughing, feeding difficulty, vomiting
- Biliary atresia: Jaundice, pale stools, dark urine, enlarged liver
- Anal atresia: No anal opening, failure to pass stool, abdominal swelling
- Pulmonary atresia: Cyanosis (bluish skin), breathing difficulties, fatigue
- Intestinal atresia: Vomiting bile, no bowel movement, swollen abdomen
Causes
- Mostly congenital (present at birth)
- May be associated with genetic mutations or chromosomal abnormalities
- Environmental factors during pregnancy
- Often linked with other birth defects or syndromes
Risk Factors
- Family history of congenital abnormalities
- Certain genetic syndromes (e.g., Down syndrome, VACTERL association)
- Maternal infections or drug exposure during pregnancy
- Premature birth (especially for intestinal atresia)
Complications
- Life-threatening obstruction or feeding issues
- Growth and developmental delays
- Risk of infection (e.g., biliary atresia can lead to liver failure)
- Long-term gastrointestinal or respiratory problems
- Need for repeated surgeries or interventions
Prevention
Atresia cannot usually be prevented, but some measures may help reduce risk:
- Prenatal care with routine ultrasounds
- Avoiding harmful substances during pregnancy
- Genetic counseling if there’s a family history of congenital conditions
- Managing maternal infections or illnesses
Treatment Options in Korea
South Korea has state-of-the-art neonatal and pediatric surgical facilities, making it one of the leading countries in Asia for treating congenital conditions like atresia.
1. Diagnosis
- Prenatal ultrasound: May detect signs of atresia in utero
- Postnatal imaging: X-rays, ultrasound, MRI, or CT scans to confirm type and location
- Blood tests and liver function tests (for biliary atresia)
- Echocardiography (for pulmonary atresia)
2. Surgical Treatment
- Esophageal Atresia: Primary anastomosis (connecting esophagus segments) or staged repair
- Biliary Atresia: Kasai procedure (hepatoportoenterostomy) is the standard initial surgery
- Anal Atresia: Anoplasty or pull-through surgery
- Intestinal Atresia: Resection of blocked section and reconnection
- Pulmonary Atresia: May require a shunt or complete heart reconstruction
Leading hospitals like Samsung Medical Center, Seoul National University Hospital, and Asan Medical Center have pediatric surgery departments with advanced facilities and neonatal intensive care units (NICUs).
3. Liver Transplantation (for Biliary Atresia)
- In cases where the Kasai procedure fails, liver transplantation may be necessary
- Korea is known for high liver transplant success rates in pediatric cases
4. Postoperative Care and Follow-up
- NICU or PICU monitoring for newborns
- Nutritional support for feeding and growth
- Regular imaging and lab tests
- Long-term follow-up with pediatric surgeons and specialists
5. Rehabilitation and Developmental Support
- Speech and feeding therapy (for esophageal or intestinal atresia)
- Growth monitoring
- Family counseling and support groups
- Assistance with long-term medical care planning
