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)