Improvised reconstruction of the esophagus in concurrent atresia and nonrotation

In the course of three years, 1985-1987, 21 children with congenital atresia of the oesophagus were operated, incl. four where the oesophagus had to be replaced by the large intestine. Each operation had unforeseen complications, all children survived, however, and are thriving. The authors describe the case of a girl with atresia type Vogt 1 who had moreover hypochromic anaemia, was a twin, premature, hypotrophic and had harelip. During the planned operation when the oesophagus was to be replaced by the large intestine at the age of 8 months, it was, however, revealed that the child has a narrow mesenterium commune with incomplete rotation. They had to perform a completely modific and improvised selection of the portion of the gut for transposition, a part of the ileum and caecum with another portion, as only that portion could be transplanted with preservation of the nurture. The gut could not be stretched because of the short mesentery. The child is now two years after the operation and development corresponds to age.