Pediatric Radiology

, Volume 44, Issue 4, pp 467–475 | Cite as

Imaging of long gap esophageal atresia and the Foker process: expected findings and complications

  • Mark C. LiszewskiEmail author
  • Sigrid Bairdain
  • Carlo Buonomo
  • Russell W. Jennings
  • George A. Taylor
Pictorial Essay


Long gap esophageal atresia (EA) is characterized by esophageal segments that are too far apart for primary anastomosis. Surgical repair utilizing interposition grafts or gastric transposition are often employed. The Foker staged lengthening procedure is an alternative surgical method that utilizes continuous traction on the esophagus to induce esophageal growth and allow for primary esophageal anastomosis. This pictorial review presents the step-by-step radiographic evaluation of the Foker procedure and illustrates the radiographic findings in the most commonly encountered complications in our cohort of 38 patients managed with this procedure from January 2000 to June 2012.


Long gap esophageal atresia Foker process Children Esophagus Esophagram 


Conflict of interest



  1. 1.
    David TJ, O'Callaghan SE (1975) Oesophageal atresia in the South West of England. J Med Genet 12:1–11PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Ein SH, Shandling B (1994) Pure esophageal atresia: a 50-year review. J Pediatr Surg 29:1208–1211PubMedCrossRefGoogle Scholar
  3. 3.
    Spitz L (1996) Esophageal atresia: past, present, and future. J Pediatr Surg 31:19–25PubMedCrossRefGoogle Scholar
  4. 4.
    Vogel AM, Yang EY, Fishman SJ (2006) Hydrostatic stretch-induced growth facilitating primary anastomosis in long-gap esophageal atresia. J Pediatr Surg 41:1170–1172PubMedCrossRefGoogle Scholar
  5. 5.
    Foker JE, Linden BC, Boyle EM Jr et al (1997) Development of a true primary repair for the full spectrum of esophageal atresia. Ann Surg 226:533–541, discussion 541-533PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Sri Paran T, Decaluwe D, Corbally M et al (2007) Long-term results of delayed primary anastomosis for pure oesophageal atresia: a 27-year follow up. Pediatr Surg Int 23:647–651PubMedCrossRefGoogle Scholar
  7. 7.
    Friedmacher F, Puri P (2012) Delayed primary anastomosis for management of long-gap esophageal atresia: a meta-analysis of complications and long-term outcome. Pediatr Surg Int 28:899–906PubMedCrossRefGoogle Scholar
  8. 8.
    Sodhi KS, Saxena AK, Ahuja CK et al (2013) Postoperative appearances of esophageal atresia repair: retrospective study of 210 patients with review of literature—what the radiologist should know. Acta Radiol 54:221–225PubMedCrossRefGoogle Scholar
  9. 9.
    Spitz L (2007) Oesophageal atresia. Orphanet J Rare Dis 2:24PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Seguier-Lipszyc E, Bonnard A, Aizenfisz S et al (2005) The management of long gap esophageal atresia. J Pediatr Surg 40:1542–1546PubMedCrossRefGoogle Scholar
  11. 11.
    Best C, Sudel B, Foker JE et al (2009) Esophageal stenting in children: indications, application, effectiveness, and complications. Gastrointest Endosc 70:1248–1253PubMedCrossRefGoogle Scholar
  12. 12.
    Kramer RE, Quiros JA (2010) Esophageal stents for severe strictures in young children: experience, benefits, and risk. Curr Gastroenterol Rep 12:203–210PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Mark C. Liszewski
    • 1
    • 2
    Email author
  • Sigrid Bairdain
    • 3
  • Carlo Buonomo
    • 1
  • Russell W. Jennings
    • 3
  • George A. Taylor
    • 1
  1. 1.Department of Radiology, Boston Children’s HospitalHarvard Medical SchoolBostonUSA
  2. 2.Rutgers Robert Wood Johnson Medical School, Department of RadiologyRobert Wood Johnson University HospitalNew BrunswickUSA
  3. 3.Department of Surgery, Boston Children’s HospitalHarvard Medical SchoolBostonUSA

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