Considered from the embryologic point of view, congenital atresia of the esophagus is surprisingly rare. Plass, 1 reviewing the literature in 1917, was able to find only 204 cases, and in Holderman's 2 survey, ten years later 218 cases were reported. The trachea develops as an outgrowth from the primitive alimentary canal by a pouching of its ventral wall. Later, separation is effected by the downgrowth of the lung bud and the upward extension of the notch between the lung bud and the esophagus. Faulty development of this tracheo-esophageal septum (Keibel and Mall) 3 or unequal division of the primitive tissue (Klebs) 4 results in various forms of congenital esophageal atresia. In by far the largest group of these cases, the upper portion of the esophagus ends blindly in a more or less dilated culdesac, while the lower portion enters either the trachea near its bifurcation or, more rarely,