Tracheoesophageal fistula

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Update Date 11/05/2020 . 3 mins read

Definition

What is tracheoesophageal fistula?

Tracheoesophageal fistula is an abnormal connection in one or more places between the esophagus (the tube that leads from the throat to the stomach) and the trachea (the tube that leads from the throat to the windpipe and lungs). Normally, the esophagus and the trachea are two separate tubes that are not connected.

Tracheoesophageal fistula is also known as TE fistula or simply TEF.

TE fistula is a birth defect, which is an abnormality that occurs as a fetus is forming in its mother’s uterus.

When a baby with a TE fistula swallows, the liquid can pass through the abnormal connection between the esophagus and the trachea. When this happens, liquid gets into the baby’s lungs. This can cause pneumonia and other problems.

There are three main types of TEF. In 85 to 90 percent of tracheoesophageal fistulas, the top part of the esophagus ends in a blind sac, and the lower part inserts into the trachea. In the second type, the upper part of the esophagus is connected directly to the trachea, while the lower part ends in a pouch. In a rare type of fistula called an H type, both the esophagus and trachea are complete, but they are connected by a small passageway. This is the most difficult type of tracheoesophageal fistula to diagnose, because both eating and breathing are possible. TEFs often occur in babies with additional birth defects.

How common is tracheoesophageal fistula?

TEFs occur in about one of every 3,000 live births. They are slightly more common in boys than in girls. Some studies suggest that the occurrence of TEFs increases with the age of the mother. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of tracheoesophageal fistula?

The common symptoms of tracheoesophageal fistula are:

  • Frothy, white bubbles in the mouth
  • Coughing or choking when feeding
  • Vomiting
  • Blue color of the skin, especially when the baby is feeding
  • Difficulty breathing
  • Very round, full abdomen

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes tracheoesophageal fistula?

As a fetus is growing and developing in its mother’s uterus before birth, different organ systems are developing and maturing. The trachea and the esophagus begin developing as one single tube. At about four to eight weeks after conception, a wall forms between the fetus’ esophagus and trachea to separate them into two distinct tubes. If this wall does not form properly, TE fistula can occur.

Risk factors

What increases my risk for tracheoesophageal fistula?

Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is tracheoesophageal fistula diagnosed?

Diagnosis that the esophagus is interrupted is confirmed by the inability to insert a nasogastric suction tube into the stomach. The exact type and location of the fistula can be determined using a radiopaque catheter, which allows pictures to be taken of the esophagus. X rays may show air in the bowels. Endoscopy often fails to locate the fistula if it is small.

How is tracheoesophageal fistula treated?

Babies with all but H type fistulas are unlikely to survive without surgical separation and repair of the trachea and the esophagus. Surgery is usually done at a hospital that has special facilities for treating seriously ill newborns. However, surgery cannot always be performed immediately because of prematurity , the presence of other birth defects, or complications from aspiration pneumonia.

While awaiting surgery, the infant’s condition is stabilized. Preoperative care concentrates on avoiding aspiration pneumonia and includes the following:

  • Elevating the head to avoid reflux and aspiration of the stomach contents
  • Using a suction catheter to continuously remove mucus and saliva that could be inhaled
  • When necessary, placement of a gastrostomy tube for feeding
  • Withholding feeding by mouth

When surgery is performed, the esophagus is reconnected to make it continuous and separate from the trachea. If the two ends of the esophagus are too far apart to be reattached, a piece of tissue from the large intestine is used to join the parts.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage tracheoesophageal fistula?

Please discuss with your doctor for further information.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Hello Health Group does not provide medical advice, diagnosis or treatment.

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