Science and Education Publishing American Journal of Medical Case Reports 2374-216X 3 12 2015 11 5 Flexible Retrograde Endoscopy before Reconstructive Surgery in Esophageal Atresia-A Case Report 387 390 EN Diaconescu Smaranda Stanca Raluca Aprodu Gabriel Sandu Sarbu Ioan Ciongradi Iulia Department of Pediatric Surgery, 'Gr. T. Popa' University of Medicine and Pharmacy, Iasi, Romania Ciubotariu Gabriela AJMCR20153121 10.12691/ajmcr-3-12-1 2015 5 16 2015 8 19 2015 11 3 In esophageal atresia multiple surgical techniques were designed to repair the esophageal conduct, the decision of choosing a specific type of intervention being strictly related to the length of esophageal gap which is mandatory for operative planning. We present a case of a newborn male with type III LADD esophageal atresia with an anastomotic leak and severe mediastinitis that complicated the primary surgical procedure and imposed cervical esophagostomy and gastrostomy. At the age of one year the child was admitted again in our unit for the esophageal reconstruction. In order to choose between an end to end suture and a procedure of esophageal replacement we tried to estimate the esophageal gap using flexible retrograde endoscopy. The operative decision was finally the esophageal replacement because the esophageal gap was longer than four vertebral bodies. Depending on endoscopist's skills the fiber optic endoscopy with radio opaque landmark and X-ray might be considered as a useful procedure in measure the gap length and surgical decision.