Surgical management of newborns with combined tracheoesophageal fistula, esophageal atresia, and duodenal obstruction

To the Editor: The incidence of esophageal atresia (EA) along with tracheoesophageal fistula (TEF) is approximately 1/3000 in newborns.[1] A large population study revealed that 46% of patients with TEF/EA had at least one of the other vertebral, anal, cardiac, tracheal, esophageal, renal, and limb (VACTERL) malformations.[2] Duodenal obstruction has an incidence of 1/7000 live births and can be caused by duodenal atresia (DA) or annular pancreas (AP).[3] AP is an uncommon congenital anomaly, and duodenal obstruction most commonly presents in the infancy or early childhood of patients.[4] The incidence of DA combined with EA varies between 3% and 6%,[5] and DA combined with EA is often associated with significant morbidity and mortality.[6]