Vacterl syndrome is a rare birth defect caused by multiple chromosomal defects early in development, affecting the vertebrae, anus, heart, lungs, kidneys and limbs. It occurs in 1 in 10,000 to 40,000 newborns. Environmental factors, early developmental issues, and genetic conditions like Trisomy 18 are potential causes. Diagnosis requires at least three of the main symptoms represented by the letters in VACTERL to be present. Long term complications depend on the severity and type of defects, and may require multiple surgeries.