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Esophageal atresia

MedGen UID:
4545
Concept ID:
C0014850
Congenital Abnormality
Synonym: Esophageal atresia (disease)
SNOMED CT: OA - Esophageal atresia (26179002); Congenital atresia of esophagus (26179002); Imperforate esophagus (26179002); Esophageal atresia (26179002)
 
HPO: HP:0002032
Monarch Initiative: MONDO:0001044

Definition

A developmental defect resulting in complete obliteration of the lumen of the esophagus such that the esophagus ends in a blind pouch rather than connecting to the stomach. [from HPO]

Term Hierarchy

Conditions with this feature

Acrocephalosyndactyly type I
MedGen UID:
7858
Concept ID:
C0001193
Congenital Abnormality
Apert syndrome is characterized by the presence of multisuture craniosynostosis, midface retrusion, and syndactyly of the hands with fusion of the second through fourth nails. Almost all affected individuals have coronal craniosynostosis, and a majority also have involvement of the sagittal and lambdoid sutures. The midface in Apert syndrome is underdeveloped as well as retruded; a subset of affected individuals have cleft palate. The hand in Apert syndrome always includes fusion of the middle three digits; the thumb and fifth finger are sometimes also involved. Feeding issues, dental abnormalities, hearing loss, hyperhidrosis, and progressive synostosis of multiple bones (skull, hands, feet, carpus, tarsus, and cervical vertebrae) are also common. Multilevel airway obstruction may be present and can be due to narrowing of the nasal passages, tongue-based airway obstruction, and/or tracheal anomalies. Nonprogressive ventriculomegaly is present in a majority of individuals, with a small subset having true hydrocephalus. Most individuals with Apert syndrome have normal intelligence or mild intellectual disability; moderate-to-severe intellectual disability has been reported in some individuals. A minority of affected individuals have structural cardiac abnormalities, true gastrointestinal malformations, and anomalies of the genitourinary tract.
Tracheoesophageal fistula
MedGen UID:
21228
Concept ID:
C0040588
Anatomical Abnormality
An abnormal connection (fistula) between the esophagus and the trachea.
Fryns syndrome
MedGen UID:
65088
Concept ID:
C0220730
Disease or Syndrome
Fryns syndrome is characterized by diaphragmatic defects (diaphragmatic hernia, eventration, hypoplasia, or agenesis); characteristic facial appearance (coarse facies, wide-set eyes, a wide and depressed nasal bridge with a broad nasal tip, long philtrum, low-set and anomalous ears, tented vermilion of the upper lip, wide mouth, and a small jaw); short distal phalanges of the fingers and toes (the nails may also be small); pulmonary hypoplasia; and associated anomalies (polyhydramnios, cloudy corneas and/or microphthalmia, orofacial clefting, renal dysplasia / renal cortical cysts, and/or malformations involving the brain, cardiovascular system, gastrointestinal system, and/or genitalia). Survival beyond the neonatal period is rare. Data on postnatal growth and psychomotor development are limited; however, severe developmental delay and intellectual disability are common.
Metaphyseal chondrodysplasia, McKusick type
MedGen UID:
67398
Concept ID:
C0220748
Congenital Abnormality
The cartilage-hair hypoplasia – anauxetic dysplasia (CHH-AD) spectrum disorders are a continuum that includes the following phenotypes: Metaphyseal dysplasia without hypotrichosis (MDWH). Cartilage-hair hypoplasia (CHH). Anauxetic dysplasia (AD). CHH-AD spectrum disorders are characterized by severe disproportionate (short-limb) short stature that is usually recognized in the newborn, and occasionally prenatally because of the short extremities. Other findings include joint hypermobility, fine silky hair, immunodeficiency, anemia, increased risk for malignancy, gastrointestinal dysfunction, and impaired spermatogenesis. The most severe phenotype, AD, has the most pronounced skeletal phenotype, may be associated with atlantoaxial subluxation in the newborn, and may include cognitive deficiency. The clinical manifestations of the CHH-AD spectrum disorders are variable, even within the same family.
CHARGE association
MedGen UID:
75567
Concept ID:
C0265354
Disease or Syndrome
CHD7 disorder encompasses the entire phenotypic spectrum of heterozygous CHD7 pathogenic variants that includes CHARGE syndrome as well as subsets of features that comprise the CHARGE syndrome phenotype. The mnemonic CHARGE syndrome, introduced in the premolecular era, stands for coloboma, heart defect, choanal atresia, retarded growth and development, genital hypoplasia, ear anomalies (including deafness). Following the identification of the genetic cause of CHD7 disorder, the phenotypic spectrum expanded to include cranial nerve anomalies, vestibular defects, cleft lip and/or palate, hypothyroidism, tracheoesophageal anomalies, brain anomalies, seizures, and renal anomalies. Life expectancy highly depends on the severity of manifestations; mortality can be high in the first few years when severe birth defects (particularly complex heart defects) are present and often complicated by airway and feeding issues. In childhood, adolescence, and adulthood, decreased life expectancy is likely related to a combination of residual heart defects, infections, aspiration or choking, respiratory issues including obstructive and central apnea, and possibly seizures. Despite these complications, the life expectancy for many individuals can be normal.
Phosphoribosylaminoimidazole carboxylase deficiency
MedGen UID:
713858
Concept ID:
C1291561
Disease or Syndrome
Phosphoribosylaminoimidazole carboxylase deficiency (PAICSD) is an autosomal recessive disorder characterized by multiple congenital anomalies and early neonatal death (Pelet et al., 2019).
Fanconi anemia complementation group B
MedGen UID:
336901
Concept ID:
C1845292
Disease or Syndrome
Fanconi anemia (FA) is characterized by physical abnormalities, bone marrow failure, and increased risk for malignancy. Physical abnormalities, present in approximately 75% of affected individuals, include one or more of the following: short stature, abnormal skin pigmentation, skeletal malformations of the upper and/or lower limbs, microcephaly, and ophthalmic and genitourinary tract anomalies. Progressive bone marrow failure with pancytopenia typically presents in the first decade, often initially with thrombocytopenia or leukopenia. The incidence of acute myeloid leukemia is 13% by age 50 years. Solid tumors – particularly of the head and neck, skin, and genitourinary tract – are more common in individuals with FA.
Anophthalmia/microphthalmia-esophageal atresia syndrome
MedGen UID:
347232
Concept ID:
C1859773
Disease or Syndrome
The phenotypic spectrum of SOX2 disorder includes anophthalmia and/or microphthalmia, brain malformations, developmental delay / intellectual disability, esophageal atresia, hypogonadotropic hypogonadism (manifest as cryptorchidism and micropenis in males, gonadal dysgenesis infrequently in females, and delayed puberty in both sexes), pituitary hypoplasia, postnatal growth delay, hypotonia, seizures, and spastic or dystonic movements.
Mandibulofacial dysostosis-microcephaly syndrome
MedGen UID:
355264
Concept ID:
C1864652
Disease or Syndrome
Mandibulofacial dysostosis with microcephaly (MFDM) is characterized by malar and mandibular hypoplasia, microcephaly (congenital or postnatal onset), intellectual disability (mild, moderate, or severe), malformations of the external ear, and hearing loss that is typically conductive. Associated craniofacial malformations may include cleft palate, choanal atresia, zygomatic arch cleft (identified on cranial CT scan), and facial asymmetry. Other relatively common findings (present in 25%-35% of individuals) can include cardiac anomalies, thumb anomalies, esophageal atresia/tracheoesophageal fistula, short stature, spine anomalies, and epilepsy.
VACTERL association, X-linked, with or without hydrocephalus
MedGen UID:
419019
Concept ID:
C2931228
Disease or Syndrome
VACTERL is an acronym for vertebral anomalies (similar to those of spondylocostal dysplasia), anal atresia, cardiac malformations, tracheoesophageal fistula, renal anomalies (urethral atresia with hydronephrosis), and limb anomalies (hexadactyly, humeral hypoplasia, radial aplasia, and proximally placed thumb; see 192350). Some patients may have hydrocephalus, which is referred to as VACTERL-H (Briard et al., 1984).
Alveolar capillary dysplasia with pulmonary venous misalignment
MedGen UID:
755478
Concept ID:
C2960310
Congenital Abnormality
Congenital alveolar capillary dysplasia with misalignment of pulmonary veins (ACDMPV) is characterized histologically by failure of formation and ingrowth of alveolar capillaries that then do not make contact with alveolar epithelium, medial muscular thickening of small pulmonary arterioles with muscularization of the intraacinar arterioles, thickened alveolar walls, and anomalously situated pulmonary veins running alongside pulmonary arterioles and sharing the same adventitial sheath. Less common features include a reduced number of alveoli and a patchy distribution of the histopathologic changes. The disorder is associated with persistent pulmonary hypertension of the neonate and shows varying degrees of lability and severity (Boggs et al., 1994). Affected infants present with respiratory distress resulting from pulmonary hypertension in the early postnatal period, and the disease is uniformly fatal within the newborn period (Vassal et al., 1998). Additional features of ACDMPV include multiple congenital anomalies affecting the cardiovascular, gastrointestinal, genitourinary, and musculoskeletal systems, as well as disruption of the normal right-left asymmetry of intrathoracic or intraabdominal organs (Sen et al., 2004).
Fanconi anemia complementation group D2
MedGen UID:
463627
Concept ID:
C3160738
Disease or Syndrome
Fanconi anemia (FA) is characterized by physical abnormalities, bone marrow failure, and increased risk for malignancy. Physical abnormalities, present in approximately 75% of affected individuals, include one or more of the following: short stature, abnormal skin pigmentation, skeletal malformations of the upper and/or lower limbs, microcephaly, and ophthalmic and genitourinary tract anomalies. Progressive bone marrow failure with pancytopenia typically presents in the first decade, often initially with thrombocytopenia or leukopenia. The incidence of acute myeloid leukemia is 13% by age 50 years. Solid tumors – particularly of the head and neck, skin, and genitourinary tract – are more common in individuals with FA.
Chromosome 17q12 duplication syndrome
MedGen UID:
482767
Concept ID:
C3281137
Disease or Syndrome
The 17q12 recurrent duplication is characterized by intellectual abilities ranging from normal to severe disability and other variable clinical manifestations. Speech delay is common, and most affected individuals have some degree of hypotonia and gross motor delay. Behavioral and psychiatric conditions reported in some affected individuals include autism spectrum disorder, schizophrenia, and behavioral abnormalities (aggression and self-injury). Seizures are present in 75%. Additional common findings include microcephaly, ocular abnormalities, and endocrine abnormalities. Short stature and renal and cardiac abnormalities are also reported in some individuals. Penetrance is incomplete and clinical findings are variable.
Fanconi anemia complementation group L
MedGen UID:
854018
Concept ID:
C3469528
Disease or Syndrome
Fanconi anemia (FA) is characterized by physical abnormalities, bone marrow failure, and increased risk for malignancy. Physical abnormalities, present in approximately 75% of affected individuals, include one or more of the following: short stature, abnormal skin pigmentation, skeletal malformations of the upper and/or lower limbs, microcephaly, and ophthalmic and genitourinary tract anomalies. Progressive bone marrow failure with pancytopenia typically presents in the first decade, often initially with thrombocytopenia or leukopenia. The incidence of acute myeloid leukemia is 13% by age 50 years. Solid tumors – particularly of the head and neck, skin, and genitourinary tract – are more common in individuals with FA.
Fanconi anemia complementation group Q
MedGen UID:
815318
Concept ID:
C3808988
Disease or Syndrome
Fanconi anemia (FA) is characterized by physical abnormalities, bone marrow failure, and increased risk for malignancy. Physical abnormalities, present in approximately 75% of affected individuals, include one or more of the following: short stature, abnormal skin pigmentation, skeletal malformations of the upper and/or lower limbs, microcephaly, and ophthalmic and genitourinary tract anomalies. Progressive bone marrow failure with pancytopenia typically presents in the first decade, often initially with thrombocytopenia or leukopenia. The incidence of acute myeloid leukemia is 13% by age 50 years. Solid tumors – particularly of the head and neck, skin, and genitourinary tract – are more common in individuals with FA.
VATER association
MedGen UID:
902479
Concept ID:
C4225671
Disease or Syndrome
VATER is a mnemonically useful acronym for the nonrandom association of vertebral defects (V), anal atresia (A), tracheoesophageal fistula with esophageal atresia (TE), and radial or renal dysplasia (R). This combination of associated defects was pointed out by Quan and Smith (1972). Nearly all cases have been sporadic. VACTERL is an acronym for an expanded definition of the association that includes cardiac malformations (C) and limb anomalies (L). The VACTERL association is a spectrum of various combinations of its 6 components, which can be a manifestation of several recognized disorders rather than a distinct anatomic or etiologic entity (Khoury et al., 1983). Also see VATER/VACTERL association with hydrocephalus (VACTERL-H; 276950) and VACTERL with or without hydrocephalus (VACTERLX; 314390).
X-linked intellectual disability, van Esch type
MedGen UID:
930741
Concept ID:
C4305072
Disease or Syndrome
Van Esch-O'Driscoll syndrome (VEODS) is characterized by varying degrees of intellectual disability, moderate to severe short stature, microcephaly, hypogonadism, and variable congenital malformations (Van Esch et al., 2019).
Feingold syndrome type 1
MedGen UID:
1637716
Concept ID:
C4551774
Disease or Syndrome
Feingold syndrome 1 (referred to as FS1 in this GeneReview) is characterized by digital anomalies (shortening of the 2nd and 5th middle phalanx of the hand, clinodactyly of the 5th finger, syndactyly of toes 2-3 and/or 4-5, thumb hypoplasia), microcephaly, facial dysmorphism (short palpebral fissures and micrognathia), gastrointestinal atresias (primarily esophageal and/or duodenal), and mild-to-moderate learning disability.
Coffin-Siris syndrome 11
MedGen UID:
1717402
Concept ID:
C5241442
Disease or Syndrome
Coffin-Siris syndrome-11 (CSS11) is a syndromic neurodevelopmental disorder characterized by global developmental delay and impaired intellectual development associated with hypotonia, feeding difficulties, and variable dysmorphic features. Most patients have distal anomalies, such as small hands and feet and hypoplastic fifth toenails (summary by Nixon et al., 2019). For a general phenotypic description and a discussion of genetic heterogeneity of Coffin-Siris syndrome, see CSS1 (135900).
Vertebral, cardiac, tracheoesophageal, renal, and limb defects
MedGen UID:
1788069
Concept ID:
C5543189
Disease or Syndrome
VCTERL syndrome is characterized by anomalies of the vertebrae, heart, trachea, esophagus, kidneys, and limbs. Some patients also exhibit craniofacial abnormalities. Incomplete penetrance and markedly variable disease expression have been observed, including intrafamilial variability (Martin et al., 2020).
Junctional epidermolysis bullosa with pyloric atresia
MedGen UID:
1810975
Concept ID:
C5676875
Disease or Syndrome
Epidermolysis bullosa with pyloric atresia (EB-PA) is characterized by fragility of the skin and mucous membranes, manifested by blistering with little or no trauma; congenital pyloric atresia; and ureteral and renal anomalies (dysplastic/multicystic kidney, hydronephrosis/hydroureter, ureterocele, duplicated renal collecting system, absent bladder). The course of EB-PA is usually severe and often lethal in the neonatal period. Most affected children succumb as neonates; those who survive may have severe blistering with formation of granulation tissue on the skin around the mouth, nose, fingers, and toes, and internally around the trachea. However, some affected individuals have little or no blistering later in life. Additional features shared by EB-PA and the other major forms of EB include congenital localized absence of skin (aplasia cutis congenita) affecting the extremities and/or head, milia, nail dystrophy, scarring alopecia, hypotrichosis, contractures, and dilated cardiomyopathy.

Professional guidelines

PubMed

Feng C, Li L, Zhang Y, Zhao Y, Huang J
Pediatr Surg Int 2023 Oct 10;39(1):280. doi: 10.1007/s00383-023-05519-6. PMID: 37815659Free PMC Article
Dingemann C, Eaton S, Aksnes G, Bagolan P, Cross KM, De Coppi P, Fruithof J, Gamba P, Husby S, Koivusalo A, Rasmussen L, Sfeir R, Slater G, Svensson JF, Van der Zee DC, Wessel LM, Widenmann-Grolig A, Wijnen R, Ure BM
Eur J Pediatr Surg 2020 Aug;30(4):326-336. Epub 2019 Jul 2 doi: 10.1055/s-0039-1693116. PMID: 31266084
Krishnan U, Mousa H, Dall'Oglio L, Homaira N, Rosen R, Faure C, Gottrand F
J Pediatr Gastroenterol Nutr 2016 Nov;63(5):550-570. doi: 10.1097/MPG.0000000000001401. PMID: 27579697

Recent clinical studies

Etiology

Feng C, Li L, Zhang Y, Zhao Y, Huang J
Pediatr Surg Int 2023 Oct 10;39(1):280. doi: 10.1007/s00383-023-05519-6. PMID: 37815659Free PMC Article
Schmedding A, Wittekindt B, Schloesser R, Hutter M, Rolle U
Dis Esophagus 2021 Apr 7;34(4) doi: 10.1093/dote/doaa093. PMID: 32995846
Krishnan U, Mousa H, Dall'Oglio L, Homaira N, Rosen R, Faure C, Gottrand F
J Pediatr Gastroenterol Nutr 2016 Nov;63(5):550-570. doi: 10.1097/MPG.0000000000001401. PMID: 27579697
Vergouwe FW, IJsselstijn H, Wijnen RM, Bruno MJ, Spaander MC
Eur J Pediatr Surg 2015 Aug;25(4):345-52. Epub 2015 Aug 24 doi: 10.1055/s-0035-1559817. PMID: 26302062
Schneider A, Michaud L, Gottrand F
Dis Esophagus 2013 May-Jun;26(4):425-7. doi: 10.1111/dote.12057. PMID: 23679037

Diagnosis

McGowan NA, Grosel J
JAAPA 2022 Jun 1;35(6):34-37. doi: 10.1097/01.JAA.0000830180.79745.b9. PMID: 35617475
Dingemann C, Eaton S, Aksnes G, Bagolan P, Cross KM, De Coppi P, Fruithof J, Gamba P, Husby S, Koivusalo A, Rasmussen L, Sfeir R, Slater G, Svensson JF, Van der Zee DC, Wessel LM, Widenmann-Grolig A, Wijnen R, Ure BM
Eur J Pediatr Surg 2020 Aug;30(4):326-336. Epub 2019 Jul 2 doi: 10.1055/s-0039-1693116. PMID: 31266084
Pardy C, D'Antonio F, Khalil A, Giuliani S
Acta Obstet Gynecol Scand 2019 Jun;98(6):689-699. Epub 2019 Mar 6 doi: 10.1111/aogs.13536. PMID: 30659586
van der Zee DC, van Herwaarden MYA, Hulsker CCC, Witvliet MJ, Tytgat SHA
Clin Perinatol 2017 Dec;44(4):753-762. Epub 2017 Sep 28 doi: 10.1016/j.clp.2017.08.002. PMID: 29127957
Martin LW, Alexander F
Surg Clin North Am 1985 Oct;65(5):1099-113. doi: 10.1016/s0039-6109(16)43731-x. PMID: 3933133

Therapy

Friedman C, Sarantos G, Katz S, Geisler S
JAAPA 2021 Feb 1;34(2):12-18. doi: 10.1097/01.JAA.0000731488.99461.39. PMID: 33448710
Pardy C, D'Antonio F, Khalil A, Giuliani S
Acta Obstet Gynecol Scand 2019 Jun;98(6):689-699. Epub 2019 Mar 6 doi: 10.1111/aogs.13536. PMID: 30659586
Morini F, Conforti A, Bagolan P
Eur J Pediatr Surg 2018 Apr;28(2):133-140. Epub 2018 Mar 13 doi: 10.1055/s-0038-1636941. PMID: 29534254
Krishnan U, Mousa H, Dall'Oglio L, Homaira N, Rosen R, Faure C, Gottrand F
J Pediatr Gastroenterol Nutr 2016 Nov;63(5):550-570. doi: 10.1097/MPG.0000000000001401. PMID: 27579697
Manfredi MA
Gastrointest Endosc Clin N Am 2016 Jan;26(1):201-19. doi: 10.1016/j.giec.2015.09.002. PMID: 26616905

Prognosis

Brooks G, Gazzaneo M, Bertozzi M, Riccipetitoni G, Raffaele A
Eur J Pediatr 2023 May;182(5):2057-2066. Epub 2023 Mar 11 doi: 10.1007/s00431-023-04893-6. PMID: 36905437Free PMC Article
Lejeune S, Sfeir R, Rousseau V, Bonnard A, Gelas T, Aumar M, Panait N, Rabattu PY, Irtan S, Fouquet V, Le Mandat A, Cocci SN, Habonimana E, Lamireau T, Lemelle JL, Elbaz F, Talon I, Boudaoud N, Allal H, Buisson P, Petit T, Sapin E, Lardy H, Schmitt F, Levard G, Scalabre A, Michel JL, Jaby O, Pelatan C, De Vries P, Borderon C, Fourcade L, Breaud J, Arnould M, Tolg C, Chaussy Y, Geiss S, Laplace C, Drumez E, El Mourad S, Thumerelle C, Gottrand F
Pediatrics 2021 Sep;148(3) Epub 2021 Aug 19 doi: 10.1542/peds.2020-049778. PMID: 34413249
Tan Tanny SP, Beck C, King SK, Hawley A, Brooks JA, McLeod E, Hutson JM, Teague WJ
Pediatrics 2021 May;147(5) doi: 10.1542/peds.2020-029884. PMID: 33911029
Godoy J, Ferraris T, Guelfand M
J Laparoendosc Adv Surg Tech A 2020 Aug;30(8):923-926. Epub 2020 Jun 17 doi: 10.1089/lap.2020.0099. PMID: 32552247
Rintala RJ, Pakarinen MP
Eur J Pediatr Surg 2013 Jun;23(3):219-25. Epub 2013 Jun 4 doi: 10.1055/s-0033-1347912. PMID: 23737132

Clinical prediction guides

Lejeune S, Sfeir R, Rousseau V, Bonnard A, Gelas T, Aumar M, Panait N, Rabattu PY, Irtan S, Fouquet V, Le Mandat A, Cocci SN, Habonimana E, Lamireau T, Lemelle JL, Elbaz F, Talon I, Boudaoud N, Allal H, Buisson P, Petit T, Sapin E, Lardy H, Schmitt F, Levard G, Scalabre A, Michel JL, Jaby O, Pelatan C, De Vries P, Borderon C, Fourcade L, Breaud J, Arnould M, Tolg C, Chaussy Y, Geiss S, Laplace C, Drumez E, El Mourad S, Thumerelle C, Gottrand F
Pediatrics 2021 Sep;148(3) Epub 2021 Aug 19 doi: 10.1542/peds.2020-049778. PMID: 34413249
Tan Tanny SP, Beck C, King SK, Hawley A, Brooks JA, McLeod E, Hutson JM, Teague WJ
Pediatrics 2021 May;147(5) doi: 10.1542/peds.2020-029884. PMID: 33911029
Dingemann C, Eaton S, Aksnes G, Bagolan P, Cross KM, De Coppi P, Fruithof J, Gamba P, Husby S, Koivusalo A, Rasmussen L, Sfeir R, Slater G, Svensson JF, Van der Zee DC, Wessel LM, Widenmann-Grolig A, Wijnen R, Ure BM
Eur J Pediatr Surg 2020 Aug;30(4):326-336. Epub 2019 Jul 2 doi: 10.1055/s-0039-1693116. PMID: 31266084
Pardy C, D'Antonio F, Khalil A, Giuliani S
Acta Obstet Gynecol Scand 2019 Jun;98(6):689-699. Epub 2019 Mar 6 doi: 10.1111/aogs.13536. PMID: 30659586
Vergouwe FW, IJsselstijn H, Wijnen RM, Bruno MJ, Spaander MC
Eur J Pediatr Surg 2015 Aug;25(4):345-52. Epub 2015 Aug 24 doi: 10.1055/s-0035-1559817. PMID: 26302062

Recent systematic reviews

Brooks G, Gazzaneo M, Bertozzi M, Riccipetitoni G, Raffaele A
Eur J Pediatr 2023 May;182(5):2057-2066. Epub 2023 Mar 11 doi: 10.1007/s00431-023-04893-6. PMID: 36905437Free PMC Article
Comella A, Tan Tanny SP, Hutson JM, Omari TI, Teague WJ, Nataraja RM, King SK
J Pediatr Surg 2021 Sep;56(9):1555-1563. Epub 2020 Sep 19 doi: 10.1016/j.jpedsurg.2020.09.010. PMID: 33051081
Drevin G, Andersson B, Svensson JF
Ann Surg 2021 Dec 1;274(6):945-953. doi: 10.1097/SLA.0000000000004239. PMID: 33002943
Pardy C, D'Antonio F, Khalil A, Giuliani S
Acta Obstet Gynecol Scand 2019 Jun;98(6):689-699. Epub 2019 Mar 6 doi: 10.1111/aogs.13536. PMID: 30659586
Miyake H, Chen Y, Hock A, Seo S, Koike Y, Pierro A
Pediatr Surg Int 2018 May;34(5):491-497. Epub 2018 Mar 13 doi: 10.1007/s00383-018-4242-4. PMID: 29536176Free PMC Article

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