Pathological study of tracheal and pulmonary lesions in autopsy cases of congenital esophageal atresia.

One of the major causes of death in infants with congenital esophageal atresia is the lung complication. Analysis of the Annual of Pathological Autopsy Cases in Japan from 1966 to 1969 revealed that the lung complications were seen in 81% of total cases. We have carried out a detailed histological study of the trachea and lung in 4 infants who died of congenital esophageal atresia. In three of them, ciliated epithelium of the trachea was replaced by stratified squamous epithelium and the alveoli were filled with numerous foamy cells. There were only a little inflammatory change in sections studied. The constant association of these two lesions suggests cause-and-effect relationship, and we are inclined to think that retention of foamy cells in the alveoli is due to the impaired mucociliary transport mechanism in the respiratory tract.