Esophageal Atresia and Tracheoesophageal Fistula – Children’s Health Issues

Esophageal atresia is a birth defect in which the esophagus narrows or does not completely form. Most newborns with esophageal atresia also have an abnormal connection between the esophagus and the windpipe (trachea) called tracheoesophageal fistula.

The esophagus is the long tubelike organ that connects the mouth to the stomach. In esophageal atresia, the esophagus is narrow or develops as two separate sections that do not connect (atresia). Because of the defect, food and fluids are delayed or prevented from going from the esophagus to the stomach.

The windpipe (trachea) is the main airway to the lungs. Normally, the esophagus and the trachea are separate. However, in tracheoesophageal fistula, an abnormal connection (fistula) forms between the esophagus and the windpipe. Because of the defect, food and fluids go into the windpipe and lungs.

Esophageal atresia and tracheoesophageal fistula often occur together.

Doctors do not know what causes esophageal atresia and tracheoesophageal fistula, but many children with these birth defects have other abnormalities, such as defects of the spine, heart, kidneys, genitals, ears, and limbs and abnormalities of mental development, physical development, or both.

Atresia and Fistula: Defects in the Esophagus

aspiration pneumonia (due to inhaling food or saliva). Food or fluid in the lungs may impair oxygenation of blood, leading to a bluish discoloration of the skin (cyanosis).

prenatal ultrasounds or after birth based on the infant’s symptoms.

If doctors suspect these defects after birth, they try to pass a tube down the infant’s esophagus. If passage of the tube is blocked, they take x-rays to confirm the diagnosis and to locate the problem.

Doctors may do other imaging tests, such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or an esophagram, to further evaluate the defect and help them plan how to repair it.

Before surgery to repair the defects can be done, preparations are done to prevent complications such as aspiration pneumonia. First, feedings by mouth are stopped, and a tube is placed in the infant’s upper esophagus to continuously suction saliva before it can reach the lungs. Then the infant is fed by vein (intravenously).