Abnormal auerbach plexus in the esophagus and stomach of patients with esophageal atresia and tracheoesophageal fistula

The Auerbach plexus of the upper gastrointestinal tract of five patients with esophageal atresia and tracheoesophageal fistula (EA-TEF) who had not had surgical reconstruction of the esophagus was studied by a microdissection technique to investigate the etiology of dysphagia, gastroesophageal reflux, and delayed gastric emptying; common findings in patients with repaired EA-TEF. All five patients showed a looser than normal Auerbach plexus in the distal esophagus, and to a lesser degree in the proximal esophagus, confirmed by point-count morphometric studies. The Auerbach plexus of the gastric fundus of all the patients was also abnormal. These findings suggest the existence of congenital functional impairment of the upper gastrointestinal tract in patients with EA-TEF, due to abnormal development of the myenteric plexus.