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VATER is a diagnosis of exclusion.

Since adolescence, he reports episodes lasting several hours during which the frequency and volume of stools increase progressively; approximately twice annually, these episodes are accompanied by emesis, painful cramping, symptomatic anemia, light-headedness, and hematochezia of unknown etiology, requiring hospitalization.

Hydrocephalus is an excessive accumulation of fluid in the skull• Patient 3 Patient 3 is a 29-year-old female with vertebral anomalies, imperforate anus, recurrent UTIs with multiple hospitalizations for pyelonephritis, urinary incontinence, and the presence of uterus didelphys, for which she underwent reconstructive surgery.

His family history is noncontributory.

Patient 11 Patient 11 is a 39-year-old female with vertebral anomalies, TEF, limb anomalies, and right postaxial polydactyly further specific details unknown, though the patient is African-American, and the description appears consistent with the polydactyly variant more commonly observed in individuals of this ethnicity [].

Also, VACTERL association can be linked to other similar conditions such as and including crossovers of conditions.

Children born with VATER syndrome require lifelong monitoring and treatment to prevent future problems.

They may also need help from specialists like a physical therapist and occupational therapist.

The disruption to fetal development that causes VACTERL association likely occurs early in development, resulting in birth defects that affect multiple body systems.

In agreement with the conclusions of Wheeler and Weaver, our patients have normal intelligence and can live independently.

In some people, the condition is likely caused by the interaction of multiple genetic and environmental factors.

Symptoms Vacterl Syndrome defects are noticeable at the time of birth and some are also analyzable through prenatal ultrasound.