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VACTERLS is an acronym used to describe categories of specific physical problems that occur together.  You need anomalies in three of the categories to be considered as having the association.

V - Vertebrae problem(s). For example, abnormally formed vertebrae, hemivertebrae, extra ribs, or sacral abnormalities.

A - Anal Anomalies and sometimes rectum problem(s). For example, there is no opening where the anus should be, called an imperforate anus; or fistulas between the rectum and urethra/vagina.

C - Cardiac (heart) problem(s). For example, there may be a hole in the heart (most commonly Ventricular Septal Defect or VSD) or a defective valve.

T - Trachea (windpipe) problem(s). For example, there is a connection between the trachea and esophagus, called a tracheal esophageal fistula.

E - Esophagus (tube from mouth to stomach) problem(s). For example, part of the esophagus is missing, called esophageal atresia.

R - Radius (lower arm bone) and/or Renal (kidney) problem(s). For example, the larger lower arm bone is abnormally formed, or a thumb is missing or absent or abnormally formed kidney.

L - Limb (arms, hands, legs or feet) problem(s). For example, there exists extra fingers or toes, shortened limbs, clubfoot.

S - Single umbilical artery. The umbilical cord had 2 blood vessels instead of three, there should be two arteries and one vein in the cord.

(adapted from the VATER Connection Information Sheet)

When a child is born with more than one of the above anomalies, the VACTERLS acronym alerts the physicians to check for problems in the other listed categories.  Early diagnosis can help to prevent unneccesary complications from occuring.
As of this time, there is no know cause for VACTERLS, and it is thought to be from a sporadic, non-genetic event occuring between the fourth and sixth week of gestation, during the formation of the major organs of the fetus.
There are a few organizations offering support for families dealing with VACTERLS.  You can join one of them, The VACTERL Network, with the link below.  See the links page for more.

Click here to join VACTERLNetwork
Click to join VACTERLNetwork