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VACTERL (or VATER as physicians refer to it sometimes) is an acronym, not a disease or a syndrome.  It is used to describe the types of anomalies (physical birth defects) children may have when they are born.
Some children have the full spectrum of VACTERL, but a child with more than two problems in any combination may be recognized as fitting the VACTERL Association.  If a physician sees at least two anomalies that fit within the VACTERL Association, he/she knows to look for other related problems.  This is important because problems that are identified early can be treated with surgery, medicine, or therapies before the child has major complications.  A child with VACTERL Association may be seen by several specialists and have several test done.
While the majority of children with VACTERL Association have normal intelligence, they may have delayed growth and development in the early years.  Examples of some of the anomalies that may occur are:
(V) - Vertebrae problems - abnormally formed vertebrae,
         tethered spinal cord, extra ribs, missing ribs and
         tailbone, etc.
(A) - Anal anomalies/rectal problems - no anal opening
(C) - Cardiac problems - minor to massive heart
(T) - Trachea (windpipe) - improper connections
         between trachea and esophagus.
(E) - Esophagus - part of the esophagus connecting the
        mouth and stomach is missing.
(R) - Renal (kidney) - abnormal kidney(s).
(L) - Limb - various hand, feet and leg problems, missing
        bone structures are common.
(S) - Single artery umbilical cord - the umbilical cord has
        one artery and one vein instead of two arteries and
        one vein.
The specific needs of each child who has VACTERL vary from child to child, as well as the severity of the anomalies.

This information is not intended to serve as medical advice.
This information was adapted from the following sources:
The VATER Connection Information Sheet
Denver VACTERL Support Group Brochure