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'''Atresia''' is a condition in which an [[body orifice|orifice]] or passage in the body is (usually abnormally) closed or absent.<ref name=":0">{{Cite book|url=https://www.worldcat.org/oclc/706780870|title=Dorland's illustrated medical dictionary.|date=2012|publisher=Saunders/Elsevier|others=Dorland, W. A. Newman (William Alexander Newman), 1864-1956.|isbn=978-1-4160-6257-8|edition=32nd|location=Philadelphia, PA|pages=174|oclc=706780870}}</ref>
'''Atresia''' is a condition in which an [[body orifice|orifice]] or passage in the body is (usually abnormally) closed or absent.<ref name=":0">{{Cite book|url=https://www.worldcat.org/oclc/706780870|title=Dorland's illustrated medical dictionary.|date=2012|publisher=Saunders/Elsevier|others=Dorland, W. A. Newman (William Alexander Newman), 1864-1956.|isbn=978-1-4160-6257-8|edition=32nd|location=Philadelphia, PA|pages=174|oclc=706780870}}</ref>


== Types ==
Examples of atresia include:
=== Anotia ===
*[[ Anotia |Aural atresia]] (anotia), a congenital deformity where the ear canal is underdeveloped.<ref>{{Cite web | last=Christensen | first=L. | title=Understanding Atresia, Microtia, and the Baha System | url=https://www.audiologyonline.com/articles/understanding-atresia-microtia-and-baha-12793 | publisher=audiologyonline | access-date=14 April 2020}}</ref>
{{Main|Anotia}}
* [[Biliary atresia]], a condition in newborns in which the common bile duct between the liver and the small intestine is blocked or absent.<ref name=pubmed2>{{cite web|last=Zieve|first=David|title=Biliary atresia|url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002130/|publisher=PubMed Health|access-date=11 September 2012}}</ref>
[[Anotia]] is characterized by the complete absence of the ear and is extremely rare. This condition may affect one or both ears, though one missing ear is more common. Anotia is also linked to [[conductive hearing loss]], a condition in which sound waves do not travel well through the ear and sound is not efficiently conducted from the outer [[ear canal]] to the [[eardrum]]. Anotia has no known cause. An associated syndrome, such as [[Treacher Collins syndrome|Treacher Collins]] or [[Goldenhar syndrome]], may affect up to 40% of patients. Anotia is typically diagnosed through a physical examination at birth. [[Obstetric ultrasonography|Prenatal ultrasounds]] may help with early detection. Total ear reconstruction is the standard treatment for Anotia.<ref name="Childrens Hospital of Philadelphia 2014 w734">{{cite web | title=Anotia | website=Children's Hospital of Philadelphia | date=July 30, 2014 |url=https://www.chop.edu/conditions-diseases/anotia | access-date=November 14, 2023}}</ref>
* [[ Bronchial atresia |Congenital bronchial atresia]], a rare congenital abnormality
* [[Choanal atresia]], blockage of the back of the nasal passage, usually by abnormal bony or soft tissue.<ref>{{cite web|last=Zieve|first=David|title=Choanal atresia|url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002608/|publisher=Pubmed Health|access-date=11 September 2012}}</ref>
* [[Esophageal atresia]], which affects the alimentary tract and causes the esophagus to end before connecting normally to the stomach.<ref>{{cite web|last=Dugdale|first=David|title=Esophageal atresia|url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001957/|publisher=PubMed Health|access-date=11 September 2012}}</ref>
*[[Follicular atresia]], degeneration and resorption of the ovarian follicles.<ref name=":0" />  
* [[Imperforate anus]], malformation of the opening between the rectum and anus.<ref name=pubmed1>{{cite web|last=Kaneshiro|first=Neil|title=Imperforate Anus|url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002132/|publisher=PubMed Health|access-date=11 September 2012}}</ref>
* [[Intestinal atresia]], malformation of the intestine, usually resulting from a vascular accident in utero.<ref>{{cite web|title=Intestinal atresia|url=http://www.pedisurg.com/pteduc/intestinal_atresia.htm|publisher=Pedisurg|access-date=11 September 2012}}</ref>
* [[Microtia]]: ''see above,'' Aural atresia (anotia).<ref>{{cite web|last=Bonilla|first=Arthuro|title=Microtia: Congenital ear deformity Institute|url=http://www.microtia.net/|publisher=Congenital ear deformity Institute|access-date=11 September 2012}}</ref>
* [[Ovarian follicle atresia]], the degeneration and subsequent resorption of one or more immature [[ovarian follicle]]s.<ref>{{Cite journal | last1 = Kaipia | first1 = A. | last2 = Hsueh | first2 = A. J. W. | doi = 10.1146/annurev.physiol.59.1.349 | title = Regulation of Ovarian Follicle Atresia | journal = Annual Review of Physiology | volume = 59 | pages = 349–363 | year = 1997 | pmid = 9074768 }}</ref>
* [[Potter sequence]], congenital decreased size of the kidney leading to absolutely no functionality of the kidney, usually related to a single kidney.
* [[Pulmonary atresia]], malformation of the pulmonary valve in which the valve orifice fails to develop.<ref>{{cite web|last=Schumacher|first=Kurt|title=Pulmonary atresia|url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002082/|publisher=PubMed Health|access-date=11 September 2012}}</ref>
* [[Renal agenesis]], only having one kidney.
* [[Tricuspid atresia]], a form of congenital heart disease whereby there is a complete absence of the tricuspid valve, and consequently an absence of the right atrioventricular connection.<ref>{{cite web|title=Tricuspid atresia|url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002100/|publisher=PubMed Health|access-date=11 September 2012}}</ref>
* [[Vaginal atresia]], a congenital occlusion of the vagina or subsequent adhesion of the walls of the vagina, resulting in its occlusion.


=== Biliary atresia ===
==References==
{{main|Biliary atresia}}
[[Biliary atresia]] (BA) is a rare disease marked by an unknown-origin [[biliary obstruction]] that manifests in the neonatal period. The classic clinical triad of Biliary atresia is acholic stools, and dark urine, [[jaundice]], and [[hepatomegaly]]. The clinical manifestations are used to make the diagnosis, which is supported by liver [[ultrasonography]], [[cholangiography]], and a [[liver biopsy]].<ref name="Chardot 2006 p. ">{{cite journal | last=Chardot | first=Christophe | title=Biliary atresia | journal=Orphanet Journal of Rare Diseases | publisher=Springer Science and Business Media LLC | volume=1 | issue=1 | date=July 26, 2006 | issn=1750-1172 | doi=10.1186/1750-1172-1-28 |url=https://ojrd.biomedcentral.com/articles/10.1186/1750-1172-1-28|access-date=November 14, 2023|doi-access=free}}</ref> The initial treatment is surgical, with the obliterated extrahepatic bile duct resected and a [[hepatoportoenterostomy]] created.<ref name="Schreiber Kleinman 2002 pp. S11–S16">{{cite journal | last=Schreiber | first=Richard A. | last2=Kleinman | first2=Ronald E. | title=Biliary Atresia | journal=Journal of Pediatric Gastroenterology and Nutrition | publisher=Ovid Technologies (Wolters Kluwer Health) | volume=35 | year=2002 | issn=0277-2116 | doi=10.1097/00005176-200207001-00005 | pages=11–16|url=https://journals.lww.com/jpgn/Fulltext/2002/07001/Biliary_Atresia.5.aspx|access-date=November 14, 2023|doi-access=free}}</ref>

=== Bronchial atresia ===
{{main|Bronchial atresia}}
[[Bronchial atresia]] is a rare congenital disease characterized by segmental or lobar [[emphysema]] and, in some cases, mucoid impaction. The exact cause of bronchial atresia is unknown; the [[Bronchus|lobar bronchi]], subsegmental bronchi, and distal bronchioles develop in the fifth, sixth, and sixteenth weeks of fetal development, respectively. Bronchial atresia is frequently discovered incidentally because it is asymptomatic. Recurrent [[Lower respiratory tract infection|pulmonary infections]] are among the most frequent clinical manifestations in symptomatic patients. Because such benign disease frequently affects young patients, minimally invasive surgery, such as thoracoscopic surgery, is advised.<ref name="Wang Dai Sun Chu 2012 pp. 207–212">{{cite journal | last=Wang | first=Yuqi | last2=Dai | first2=Weimin | last3=Sun | first3=Yu'e | last4=Chu | first4=Xiangyang | last5=Yang | first5=Bo | last6=Zhao | first6=Ming | title=Congenital Bronchial Atresia: Diagnosis and Treatment | journal=International Journal of Medical Sciences | publisher=Ivyspring International Publisher | volume=9 | issue=3 | year=2012 | issn=1449-1907 | doi=10.7150/ijms.3690 | pages=207–212|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298011/|access-date=November 14, 2023|doi-access=free}}</ref>

=== Choanal atresia ===
{{main|Choanal atresia}}
[[Choanal atresia]] (CA) is a rare but well-known condition marked by the anatomical closure of the posterior [[choana]]e in the [[nasal cavity]]. CA presents clinically in a variety of ways, ranging from acute [[airway obstruction]] to chronic recurrent [[sinusitis]], depending on whether it is unilateral, bilateral, or paired with other coexisting airway abnormalities, as is common in individuals who have [[CHARGE syndrome]] and craniofacial anomalies. The initial clinical evaluation consists of inserting a six or eight Fr [[Yankauer suction tip|suction catheter]] through the nostrils, performing a [[Methylene blue|methylene]] blue dye test, a cotton wisp test, and a laryngeal mirror test. In patients with proper nasal preparation, a CT of the sinuses with 2-5 mm cuts provides a definitive evaluation.<ref name="Kwong 2015 p. ">{{cite journal | last=Kwong | first=Kelvin M. | title=Current Updates on Choanal Atresia | journal=Frontiers in Pediatrics | publisher=Frontiers Media SA | volume=3 | date=June 9, 2015 | issn=2296-2360 | doi=10.3389/fped.2015.00052 |url=https://www.frontiersin.org/articles/10.3389/fped.2015.00052/full|access-date=November 14, 2023|doi-access=free}}</ref>

=== Esophageal atresia ===
{{main|Esophageal atresia}}
[[Esophageal atresia]] (EA) is a rare congenital malformation characterized by a lack of continuity between the lower and upper esophageal pouches, often associated with [[tracheoesophageal fistula]].<ref name="Sfeir Michaud Salleron Gottrand 2013 pp. 354–355">{{cite journal | last=Sfeir | first=R. | last2=Michaud | first2=L. | last3=Salleron | first3=J. | last4=Gottrand | first4=F. | title=Epidemiology of esophageal atresia | journal=Diseases of the Esophagus | publisher=Oxford University Press (OUP) | volume=26 | issue=4 | year=2013 | issn=1120-8694 | doi=10.1111/dote.12051 | pages=354–355|url=https://academic.oup.com/dote/article/26/4/354/2328831?login=false|access-date=November 14, 2023|doi-access=free
}}</ref> Esophageal atresia with or without tracheoesophageal fistula (TEF) is the most common birth defect of the [[esophagus]]. The diagnosis of EA usually occurs within the first 24 hours of life, but it can be made antenatally or later.<ref name="Pinheiro 2012 p. 3662">{{cite journal | last=Pinheiro | first=Paulo Fernando Martins | title=Current knowledge on esophageal atresia | journal=World Journal of Gastroenterology | publisher=Baishideng Publishing Group Inc. | volume=18 | issue=28 | year=2012 | issn=1007-9327 | doi=10.3748/wjg.v18.i28.3662 | page=3662|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3406418/|access-date=November 14, 2023|doi-access=free}}</ref> Although environmental effects and genetic factors have been documented, the causes of EA remain largely unknown.<ref name="Sfeir Bonnard Khen-Dunlop Auber 2013 pp. 1664–1669">{{cite journal | last=Sfeir | first=Rony | last2=Bonnard | first2=Arnaud | last3=Khen-Dunlop | first3=Naziha | last4=Auber | first4=Frederic | last5=Gelas | first5=Thomas | last6=Michaud | first6=Laurent | last7=Podevin | first7=Guillaume | last8=Breton | first8=Anne | last9=Fouquet | first9=Virginie | last10=Piolat | first10=Christian | last11=Lemelle | first11=Jean Louis | last12=Petit | first12=Thierry | last13=Lavrand | first13=Frederic | last14=Becmeur | first14=Francis | last15=Polimerol | first15=Marie Laurence | last16=Michel | first16=Jean Luc | last17=Elbaz | first17=Frederic | last18=Habonimana | first18=Eric | last19=Allal | first19=Hassan | last20=Lopez | first20=Emmanuel | last21=Lardy | first21=Hubert | last22=Morineau | first22=Marianne | last23=Pelatan | first23=Cécile | last24=Merrot | first24=Thierry | last25=Delagausie | first25=Pascal | last26=de Vries | first26=Philline | last27=Levard | first27=Guillaume | last28=Buisson | first28=Phillippe | last29=Sapin | first29=Emmanuel | last30=Jaby | first30=Olivier | last31=Borderon | first31=Corinne | last32=Weil | first32=Dominique | last33=Gueiss | first33=Stephane | last34=Aubert | first34=Didier | last35=Echaieb | first35=Anais | last36=Fourcade | first36=Laurent | last37=Breaud | first37=Jean | last38=Laplace | first38=Christophe | last39=Pouzac | first39=Myriam | last40=Duhamel | first40=Alain | last41=Gottrand | first41=Frederic | title=Esophageal atresia: Data from a national cohort | journal=Journal of Pediatric Surgery | publisher=Elsevier BV | volume=48 | issue=8 | year=2013 | issn=0022-3468 | doi=10.1016/j.jpedsurg.2013.03.075 | pages=1664–1669|url=https://www.sciencedirect.com/science/article/abs/pii/S0022346813003898|access-date=November 14, 2023
}}</ref> Treatment is surgical and includes reconstruction of the continuity of the esophagus or replacement by other organs.<ref name="Höllwarth Till 2020 pp. 661–680">{{cite book | last=Höllwarth | first=Michael E. | last2=Till | first2=Holger | title=Pediatric Surgery | chapter=Esophageal Atresia | publisher=Springer Berlin Heidelberg | publication-place=Berlin, Heidelberg | year=2020 | doi=10.1007/978-3-662-43588-5_48 | page=661–680|url=https://link.springer.com/referenceworkentry/10.1007/978-3-662-43588-5_48|access-date=November 14, 2023}}</ref>

=== Follicular atresia ===
{{main|Follicular atresia}}
[[Follicular atresia]] refers to the process in which a [[Ovarian follicle|follicle]] fails to develop, thus preventing it from [[Ovulation|ovulating]] and releasing an egg.<ref>{{cite book | vauthors = McGee EA, Horne J | chapter = Follicle Atresia |date=2018 | title = Encyclopedia of Reproduction | edition = Second |pages=87–91 | veditors = Skinner MK |place=Oxford |publisher=Academic Press |language=en |doi=10.1016/b978-0-12-801238-3.64395-7 |isbn=978-0-12-815145-7 }}</ref> It is a normal, naturally occurring progression that occurs as mammalian [[Ovary|ovaries]] age. Approximately 1% of mammalian follicles in ovaries undergo ovulation and the remaining 99% of follicles go through follicular atresia as they cycle through the growth phases. In summary, follicular atresia is a process that leads to the follicular loss and loss of oocytes, and any disturbance or loss of functionality of this process can lead to many other conditions.<ref name="Liu_2020">{{cite journal | vauthors = Liu Z, Li F, Xue J, Wang M, Lai S, Bao H, He S | title = Esculentoside A rescues granulosa cell apoptosis and folliculogenesis in mice with premature ovarian failure | journal = Aging | volume = 12 | issue = 17 | pages = 16951–16962 | date = August 2020 | pmid = 32759462 | pmc = 7521512 | doi = 10.18632/aging.103609 }}</ref>

=== Imperforate anus ===
{{main|Imperforate anus}}
[[Imperforate anus]] is a somewhat common anomaly, with a newborn incidence ranging from 1: 1500 to 1:5000. There have been isolated cases of imperforate anus, but this condition is more commonly found as one among numerous anomalies. Imperforate anus is usually not diagnosed until after birth. There is no need for immediate reconstructive anorectal surgery. However, prompt evaluation is critical, and urgent decompressive surgery may be required.<ref name="Brantberg Blaas Haugen Isaksen 2006 pp. 904–910">{{cite journal | last=Brantberg | first=A. | last2=Blaas | first2=H.‐G. K. | last3=Haugen | first3=S. E. | last4=Isaksen | first4=C. V. | last5=Eik‐Nes | first5=S. H. | title=Imperforate anus: a relatively common anomaly rarely diagnosed prenatally | journal=Ultrasound in Obstetrics &amp; Gynecology | publisher=Wiley | volume=28 | issue=7 | date=November 23, 2006 | issn=0960-7692 | doi=10.1002/uog.3862 | pages=904–910|url=https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/uog.3862|access-date=November 14, 2023|doi-access=free}}</ref>

=== Intestinal atresia ===
{{main|Intestinal atresia}}
With an incidence of 1 in 5,000 newborns, [[intestinal atresia]]s are one of the most common causes of neonatal [[Bowel obstruction|intestinal obstruction]]. The majority of cases are [[Small intestine|small intestinal]] atresia, while colonic atresias are uncommon.<ref name="Subbarayan 2015 p. ">{{cite journal | last=Subbarayan | first=Devi | title=Histomorphological Features of Intestinal Atresia and its Clinical Correlation | journal=JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH | publisher=JCDR Research and Publications | year=2015 | issn=2249-782X | doi=10.7860/jcdr/2015/13320.6838 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4668418/|access-date=November 14, 2023|doi-access=free}}</ref> There have been two main etiologies proposed for intestinal atresia: the first is a lack of re-[[vacuolization]] of the solid cord stage of intestinal development, and the second is a late intrauterine mesenteric vascular accident. [[Obstetric ultrasonography|Prenatal ultrasonography]] is the most reliable way to diagnose intestinal artesia. Pre-operative management includes primary resuscitation, correction of [[dehydration]], and correction of electrolyte abnormalities. Kimura's diamond-shaped duodeno-duodenostomy is the most common surgical treatment.<ref name="Gupta Gupta Ghosh Gupta 2016 p. 51">{{cite journal | last=Gupta | first=Shilpi | last2=Gupta | first2=Rahul | last3=Ghosh | first3=Soumyodhriti | last4=Gupta | first4=Arun Kumar | last5=Shukla | first5=Arvind | last6=Chaturvedi | first6=Vinita | last7=Mathur | first7=Praveen | title=Intestinal Atresia: Experience at a Busy Center of North-West India | journal=Journal of Neonatal Surgery | publisher=Journal of Neonatal Surgery | volume=5 | issue=4 | date=October 7, 2016 | issn=2226-0439 | doi=10.21699/jns.v5i4.405 | page=51|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5117274/|access-date=November 14, 2023|doi-access=free}}</ref>

=== Microtia ===
{{main|Microtia}}
Microtia is a [[congenital disorder|congenital deformity]] where the [[auricle (anatomy)|auricle]] (external ear) is underdeveloped. A completely undeveloped pinna is referred to as [[anotia]]. Because microtia and anotia have the same origin, it can be referred to as microtia-anotia.<ref name=omim>{{OMIM|600674|Microtia-Anotia}}</ref> Microtia can be unilateral (one side only) or bilateral (affecting both sides). Microtia occurs in 1 out of about 8,000–10,000 births. In unilateral microtia, the right ear is most commonly affected. It may occur as a complication of taking [[Accutane]] (isotretinoin) during pregnancy.<ref>Pretest self assessment and review for the USMLE, pediatrics, 12th edition, question 84, general pediatrics</ref>

=== Potter sequence ===
{{main|Potter sequence}}
[[Potter sequence|Potter's sequence]] is a fatal sporadic and [[Dominance (genetics)|autosomal recessive disorder]] with an incidence of 1 in 4000 births. Babies born with this defect are either [[Stillbirth|stillborn]] or die very soon after birth. It primarily affects male babies and is associated with severe [[oligohydramnios]], [[Polycystic kidney disease|polycystic kidney]], bilateral [[renal agenesis]], and [[obstructive uropathy]] during the middle gestational weeks. The main defect in Potter's sequence is [[Kidney failure|renal failure]]. [[Preterm birth|Premature birth]], [[Breech birth|breech presentation]], atypical facial appearance, and limb malformations are other distinguishing characteristics. In most infants, severe [[Respiratory failure|respiratory insufficiency]] results in death.<ref name="Shastry Kolte Sanagapati 2012 p. 157">{{cite journal | last=Shastry | first=SrikanthM | last2=Kolte | first2=SachinS | last3=Sanagapati | first3=PandurangaR | title=Potter′s sequence | journal=Journal of Clinical Neonatology | publisher=Medknow | volume=1 | issue=3 | year=2012 | issn=2249-4847 | doi=10.4103/2249-4847.101705 | page=157|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762025/|access-date=November 14, 2023|doi-access=free}}</ref>

=== Renal agenesis ===
{{main|Renal agenesis}}
[[Renal agenesis]] occurs when the [[ureteric bud]] doesn't fuse with the [[Metanephrogenic blastema|metanephric blastema]] during [[embryogenesis]], leading to the nephron and, in some cases, the ureter being absent. Unilateral renal agenesis occurs in 1 in 1000 live births, in contrast bilateral renal agenesis occurs in 1 in 3000 to 4000 pregnancies. Unilateral renal agenesis has a very good prognosis, whereas bilateral renal agenesis has a high rate of perinatal mortality and morbidity due to the lack of [[amniotic fluid]], resulting in lethal [[pulmonary hypoplasia]]. The diagnosis of renal agenesis is usually made during a midgestation anatomy ultrasound examination. A genetic syndrome or other anomalies are linked to approximately 30% of cases of renal agenesis.<ref name="Jelin 2021 pp. B28–B30">{{cite journal | last=Jelin | first=Angie | title=Renal agenesis | journal=American Journal of Obstetrics and Gynecology | publisher=Elsevier BV | volume=225 | issue=5 | year=2021 | issn=0002-9378 | doi=10.1016/j.ajog.2021.06.048 | pages=28–30|url=https://www.ajog.org/article/S0002-9378(21)00681-5/fulltext|access-date=November 14, 2023|doi-access=free}}</ref>

=== Tricuspid atresia ===
{{main|Tricuspid atresia}}
[[Tricuspid atresia]] is a form of [[congenital heart disease]] whereby there is a complete absence of the [[tricuspid valve]].<ref name="00">{{Citation|last1=Murthy|first1=Raghav|title=65 - Tricuspid Atresia|date=2019-01-01|url=http://www.sciencedirect.com/science/article/pii/B9781455707607000656|work=Critical Heart Disease in Infants and Children (Third Edition)|pages=765–777.e3|editor-last=Ungerleider|editor-first=Ross M.|place=Philadelphia|publisher=Elsevier|language=en|doi=10.1016/b978-1-4557-0760-7.00065-6|isbn=978-1-4557-0760-7|access-date=2020-11-27|last2=Nigro|first2=John|last3=Karamlou|first3=Tara|s2cid=214741527 |editor2-last=Meliones|editor2-first=Jon N.|editor3-last=Nelson McMillan|editor3-first=Kristen|editor4-last=Cooper|editor4-first=David S.}}</ref> Therefore, there is an absence of right atrioventricular connection.<ref name="00" /> This leads to a [[hypoplastic]] (undersized) or absent [[right ventricle]]. This defect is contracted during [[prenatal development]], when the [[heart]] does not finish [[Heart development|developing]]. It causes the systemic circulation to be filled with relatively deoxygenated blood. The causes of tricuspid atresia are unknown.<ref name=":2">{{Cite web |url=https://www.cdc.gov/ncbddd/heartdefects/tricuspid-atresia.html |title = Congenital Heart Defects&nbsp;— Facts about Tricuspid Atresia &#124; CDC|date = 2019-01-22}}</ref>

=== Vaginal atresia ===
{{main|Vaginal atresia}}
[[Vaginal atresia]] is a birth defect that causes uterovaginal outflow tract obstruction. It happens when the [[urogenital sinus]] fails to form the caudal portion of the vagina. [[Connective tissue|Fibrous tissue]] replaces the caudal portion of the vagina. Vaginal atresia is thought to affect one in every 5000-10,000 live female births. The anomaly is frequently undetected until adolescence, when primary [[amenorrhea]] or [[abdominal pain]] caused by an obstructed uterovaginal tract leads to a diagnostic evaluation.<ref name="Saxena 2021 x092">{{cite web | last=Saxena | first=Amulya K | title=Vaginal Atresia: Practice Essentials, Anatomy, Pathophysiology | website=Medscape Reference | date=November 9, 2021 |url=https://emedicine.medscape.com/article/954110-overview | access-date=November 14, 2023}}</ref>

== References ==
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[[Category:Anatomy]]
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{{Disease-stub}}

Revision as of 23:00, 14 November 2023

Atresia is a condition in which an orifice or passage in the body is (usually abnormally) closed or absent.[1]

Types

Anotia

Main article: Anotia

Anotia is characterized by the complete absence of the ear and is extremely rare. This condition may affect one or both ears, though one missing ear is more common. Anotia is also linked to conductive hearing loss, a condition in which sound waves do not travel well through the ear and sound is not efficiently conducted from the outer ear canal to the eardrum. Anotia has no known cause. An associated syndrome, such as Treacher Collins or Goldenhar syndrome, may affect up to 40% of patients. Anotia is typically diagnosed through a physical examination at birth. Prenatal ultrasounds may help with early detection. Total ear reconstruction is the standard treatment for Anotia.[2]

Biliary atresia

Main article: Biliary atresia

Biliary atresia (BA) is a rare disease marked by an unknown-origin biliary obstruction that manifests in the neonatal period. The classic clinical triad of Biliary atresia is acholic stools, and dark urine, jaundice, and hepatomegaly. The clinical manifestations are used to make the diagnosis, which is supported by liver ultrasonography, cholangiography, and a liver biopsy.[3] The initial treatment is surgical, with the obliterated extrahepatic bile duct resected and a hepatoportoenterostomy created.[4]

Bronchial atresia

Main article: Bronchial atresia

Bronchial atresia is a rare congenital disease characterized by segmental or lobar emphysema and, in some cases, mucoid impaction. The exact cause of bronchial atresia is unknown; the lobar bronchi, subsegmental bronchi, and distal bronchioles develop in the fifth, sixth, and sixteenth weeks of fetal development, respectively. Bronchial atresia is frequently discovered incidentally because it is asymptomatic. Recurrent pulmonary infections are among the most frequent clinical manifestations in symptomatic patients. Because such benign disease frequently affects young patients, minimally invasive surgery, such as thoracoscopic surgery, is advised.[5]

Choanal atresia

Main article: Choanal atresia

Choanal atresia (CA) is a rare but well-known condition marked by the anatomical closure of the posterior choanae in the nasal cavity. CA presents clinically in a variety of ways, ranging from acute airway obstruction to chronic recurrent sinusitis, depending on whether it is unilateral, bilateral, or paired with other coexisting airway abnormalities, as is common in individuals who have CHARGE syndrome and craniofacial anomalies. The initial clinical evaluation consists of inserting a six or eight Fr suction catheter through the nostrils, performing a methylene blue dye test, a cotton wisp test, and a laryngeal mirror test. In patients with proper nasal preparation, a CT of the sinuses with 2-5 mm cuts provides a definitive evaluation.[6]

Esophageal atresia

Main article: Esophageal atresia

Esophageal atresia (EA) is a rare congenital malformation characterized by a lack of continuity between the lower and upper esophageal pouches, often associated with tracheoesophageal fistula.[7] Esophageal atresia with or without tracheoesophageal fistula (TEF) is the most common birth defect of the esophagus. The diagnosis of EA usually occurs within the first 24 hours of life, but it can be made antenatally or later.[8] Although environmental effects and genetic factors have been documented, the causes of EA remain largely unknown.[9] Treatment is surgical and includes reconstruction of the continuity of the esophagus or replacement by other organs.[10]

Follicular atresia

Main article: Follicular atresia

Follicular atresia refers to the process in which a follicle fails to develop, thus preventing it from ovulating and releasing an egg.[11] It is a normal, naturally occurring progression that occurs as mammalian ovaries age. Approximately 1% of mammalian follicles in ovaries undergo ovulation and the remaining 99% of follicles go through follicular atresia as they cycle through the growth phases. In summary, follicular atresia is a process that leads to the follicular loss and loss of oocytes, and any disturbance or loss of functionality of this process can lead to many other conditions.[12]

Imperforate anus

Main article: Imperforate anus

Imperforate anus is a somewhat common anomaly, with a newborn incidence ranging from 1: 1500 to 1:5000. There have been isolated cases of imperforate anus, but this condition is more commonly found as one among numerous anomalies. Imperforate anus is usually not diagnosed until after birth. There is no need for immediate reconstructive anorectal surgery. However, prompt evaluation is critical, and urgent decompressive surgery may be required.[13]

Intestinal atresia

Main article: Intestinal atresia

With an incidence of 1 in 5,000 newborns, intestinal atresias are one of the most common causes of neonatal intestinal obstruction. The majority of cases are small intestinal atresia, while colonic atresias are uncommon.[14] There have been two main etiologies proposed for intestinal atresia: the first is a lack of re-vacuolization of the solid cord stage of intestinal development, and the second is a late intrauterine mesenteric vascular accident. Prenatal ultrasonography is the most reliable way to diagnose intestinal artesia. Pre-operative management includes primary resuscitation, correction of dehydration, and correction of electrolyte abnormalities. Kimura's diamond-shaped duodeno-duodenostomy is the most common surgical treatment.[15]

Microtia

Main article: Microtia

Microtia is a congenital deformity where the auricle (external ear) is underdeveloped. A completely undeveloped pinna is referred to as anotia. Because microtia and anotia have the same origin, it can be referred to as microtia-anotia.[16] Microtia can be unilateral (one side only) or bilateral (affecting both sides). Microtia occurs in 1 out of about 8,000–10,000 births. In unilateral microtia, the right ear is most commonly affected. It may occur as a complication of taking Accutane (isotretinoin) during pregnancy.[17]

Potter sequence

Main article: Potter sequence

Potter's sequence is a fatal sporadic and autosomal recessive disorder with an incidence of 1 in 4000 births. Babies born with this defect are either stillborn or die very soon after birth. It primarily affects male babies and is associated with severe oligohydramnios, polycystic kidney, bilateral renal agenesis, and obstructive uropathy during the middle gestational weeks. The main defect in Potter's sequence is renal failure. Premature birth, breech presentation, atypical facial appearance, and limb malformations are other distinguishing characteristics. In most infants, severe respiratory insufficiency results in death.[18]

Renal agenesis

Main article: Renal agenesis

Renal agenesis occurs when the ureteric bud doesn't fuse with the metanephric blastema during embryogenesis, leading to the nephron and, in some cases, the ureter being absent. Unilateral renal agenesis occurs in 1 in 1000 live births, in contrast bilateral renal agenesis occurs in 1 in 3000 to 4000 pregnancies. Unilateral renal agenesis has a very good prognosis, whereas bilateral renal agenesis has a high rate of perinatal mortality and morbidity due to the lack of amniotic fluid, resulting in lethal pulmonary hypoplasia. The diagnosis of renal agenesis is usually made during a midgestation anatomy ultrasound examination. A genetic syndrome or other anomalies are linked to approximately 30% of cases of renal agenesis.[19]

Tricuspid atresia

Main article: Tricuspid atresia

Tricuspid atresia is a form of congenital heart disease whereby there is a complete absence of the tricuspid valve.Cite error: The <ref> tag name cannot be a simple integer (see the help page). Therefore, there is an absence of right atrioventricular connection.Cite error: The <ref> tag name cannot be a simple integer (see the help page). This leads to a hypoplastic (undersized) or absent right ventricle. This defect is contracted during prenatal development, when the heart does not finish developing. It causes the systemic circulation to be filled with relatively deoxygenated blood. The causes of tricuspid atresia are unknown.[20]

Vaginal atresia

Main article: Vaginal atresia

Vaginal atresia is a birth defect that causes uterovaginal outflow tract obstruction. It happens when the urogenital sinus fails to form the caudal portion of the vagina. Fibrous tissue replaces the caudal portion of the vagina. Vaginal atresia is thought to affect one in every 5000-10,000 live female births. The anomaly is frequently undetected until adolescence, when primary amenorrhea or abdominal pain caused by an obstructed uterovaginal tract leads to a diagnostic evaluation.[21]

References

  1. ^ Dorland's illustrated medical dictionary. Dorland, W. A. Newman (William Alexander Newman), 1864-1956. (32nd ed.). Philadelphia, PA: Saunders/Elsevier. 2012. p. 174. ISBN 978-1-4160-6257-8. OCLC 706780870.{{cite book}}: CS1 maint: others (link)
  2. ^ "Anotia". Children's Hospital of Philadelphia. July 30, 2014. Retrieved November 14, 2023.
  3. ^ Chardot, Christophe (July 26, 2006). "Biliary atresia". Orphanet Journal of Rare Diseases. 1 (1). Springer Science and Business Media LLC. doi:10.1186/1750-1172-1-28. ISSN 1750-1172. Retrieved November 14, 2023.
  4. ^ Schreiber, Richard A.; Kleinman, Ronald E. (2002). "Biliary Atresia". Journal of Pediatric Gastroenterology and Nutrition. 35. Ovid Technologies (Wolters Kluwer Health): 11–16. doi:10.1097/00005176-200207001-00005. ISSN 0277-2116. Retrieved November 14, 2023.
  5. ^ Wang, Yuqi; Dai, Weimin; Sun, Yu'e; Chu, Xiangyang; Yang, Bo; Zhao, Ming (2012). "Congenital Bronchial Atresia: Diagnosis and Treatment". International Journal of Medical Sciences. 9 (3). Ivyspring International Publisher: 207–212. doi:10.7150/ijms.3690. ISSN 1449-1907. Retrieved November 14, 2023.
  6. ^ Kwong, Kelvin M. (June 9, 2015). "Current Updates on Choanal Atresia". Frontiers in Pediatrics. 3. Frontiers Media SA. doi:10.3389/fped.2015.00052. ISSN 2296-2360. Retrieved November 14, 2023.
  7. ^ Sfeir, R.; Michaud, L.; Salleron, J.; Gottrand, F. (2013). "Epidemiology of esophageal atresia". Diseases of the Esophagus. 26 (4). Oxford University Press (OUP): 354–355. doi:10.1111/dote.12051. ISSN 1120-8694. Retrieved November 14, 2023.
  8. ^ Pinheiro, Paulo Fernando Martins (2012). "Current knowledge on esophageal atresia". World Journal of Gastroenterology. 18 (28). Baishideng Publishing Group Inc.: 3662. doi:10.3748/wjg.v18.i28.3662. ISSN 1007-9327. Retrieved November 14, 2023.
  9. ^ Sfeir, Rony; Bonnard, Arnaud; Khen-Dunlop, Naziha; Auber, Frederic; Gelas, Thomas; Michaud, Laurent; Podevin, Guillaume; Breton, Anne; Fouquet, Virginie; Piolat, Christian; Lemelle, Jean Louis; Petit, Thierry; Lavrand, Frederic; Becmeur, Francis; Polimerol, Marie Laurence; Michel, Jean Luc; Elbaz, Frederic; Habonimana, Eric; Allal, Hassan; Lopez, Emmanuel; Lardy, Hubert; Morineau, Marianne; Pelatan, Cécile; Merrot, Thierry; Delagausie, Pascal; de Vries, Philline; Levard, Guillaume; Buisson, Phillippe; Sapin, Emmanuel; Jaby, Olivier; Borderon, Corinne; Weil, Dominique; Gueiss, Stephane; Aubert, Didier; Echaieb, Anais; Fourcade, Laurent; Breaud, Jean; Laplace, Christophe; Pouzac, Myriam; Duhamel, Alain; Gottrand, Frederic (2013). "Esophageal atresia: Data from a national cohort". Journal of Pediatric Surgery. 48 (8). Elsevier BV: 1664–1669. doi:10.1016/j.jpedsurg.2013.03.075. ISSN 0022-3468. Retrieved November 14, 2023.
  10. ^ Höllwarth, Michael E.; Till, Holger (2020). "Esophageal Atresia". Pediatric Surgery. Berlin, Heidelberg: Springer Berlin Heidelberg. p. 661–680. doi:10.1007/978-3-662-43588-5_48. Retrieved November 14, 2023.
  11. ^ McGee EA, Horne J (2018). "Follicle Atresia". In Skinner MK (ed.). Encyclopedia of Reproduction (Second ed.). Oxford: Academic Press. pp. 87–91. doi:10.1016/b978-0-12-801238-3.64395-7. ISBN 978-0-12-815145-7.
  12. ^ Liu Z, Li F, Xue J, Wang M, Lai S, Bao H, He S (August 2020). "Esculentoside A rescues granulosa cell apoptosis and folliculogenesis in mice with premature ovarian failure". Aging. 12 (17): 16951–16962. doi:10.18632/aging.103609. PMC 7521512. PMID 32759462.
  13. ^ Brantberg, A.; Blaas, H.‐G. K.; Haugen, S. E.; Isaksen, C. V.; Eik‐Nes, S. H. (November 23, 2006). "Imperforate anus: a relatively common anomaly rarely diagnosed prenatally". Ultrasound in Obstetrics & Gynecology. 28 (7). Wiley: 904–910. doi:10.1002/uog.3862. ISSN 0960-7692. Retrieved November 14, 2023.
  14. ^ Subbarayan, Devi (2015). "Histomorphological Features of Intestinal Atresia and its Clinical Correlation". JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. JCDR Research and Publications. doi:10.7860/jcdr/2015/13320.6838. ISSN 2249-782X. Retrieved November 14, 2023.
  15. ^ Gupta, Shilpi; Gupta, Rahul; Ghosh, Soumyodhriti; Gupta, Arun Kumar; Shukla, Arvind; Chaturvedi, Vinita; Mathur, Praveen (October 7, 2016). "Intestinal Atresia: Experience at a Busy Center of North-West India". Journal of Neonatal Surgery. 5 (4). Journal of Neonatal Surgery: 51. doi:10.21699/jns.v5i4.405. ISSN 2226-0439. Retrieved November 14, 2023.
  16. ^ Online Mendelian Inheritance in Man (OMIM): Microtia-Anotia - 600674
  17. ^ Pretest self assessment and review for the USMLE, pediatrics, 12th edition, question 84, general pediatrics
  18. ^ Shastry, SrikanthM; Kolte, SachinS; Sanagapati, PandurangaR (2012). "Potter′s sequence". Journal of Clinical Neonatology. 1 (3). Medknow: 157. doi:10.4103/2249-4847.101705. ISSN 2249-4847. Retrieved November 14, 2023.
  19. ^ Jelin, Angie (2021). "Renal agenesis". American Journal of Obstetrics and Gynecology. 225 (5). Elsevier BV: 28–30. doi:10.1016/j.ajog.2021.06.048. ISSN 0002-9378. Retrieved November 14, 2023.
  20. ^ "Congenital Heart Defects — Facts about Tricuspid Atresia | CDC". 2019-01-22.
  21. ^ Saxena, Amulya K (November 9, 2021). "Vaginal Atresia: Practice Essentials, Anatomy, Pathophysiology". Medscape Reference. Retrieved November 14, 2023.
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