Esophageal atresia is a narrowing or obstruction of the esophagus. Tracheoesophageal fistula is a connection or hole between the lower esophagus and the trachea (the windpipe).

Alternative Names

Tracheoesophageal fistula

Causes, incidence, and risk factors

Esophageal atresia is a disorder of the digestive system that occurs as a congenital anomaly. There are several types of esophageal atresia. In most cases, the upper esophagus ends blindly and does not connect with the lower esophagus and stomach. The top end of the lower esophagus is connected with the trachea. This connection between the lower esophagus and the trachea is called a tracheoesophageal fistula (often abbreviated TEF). Over 30% of people affected with this condition will have other abnormalities such as heart disorders or other gastrointestinal tract disorders. This condition is frequently complicated by aspiration of saliva and secretions into the lungs, causing pneumonia , choking , and possibly death. It is considered a surgical emergency. The disorder is usually detected shortly after birth when feeding is attempted and the infant coughs, chokes, and turns blue ( cyanosis ). Immediate surgical repair of this disorder is indicated so that the lungs are not damaged and the baby can be fed. Esophageal atresia and TEF occur in approximately 2 or 3 infants per 10,000 births.

Signs and tests

Prenatally, excessive amniotic fluid (polyhydramnios) will arouse suspicion of esophageal atresia or other obstruction of the gastrointestinal tract. As soon as the diagnosis is suspected, an attempt to pass a small feeding tube (nasogastric tube) through the mouth or nose into the stomach should be made. The feeding tube will not be able to pass all the way to the stomach in a baby with esophageal atresia. An X-ray of the esophagus shows an air filled pouch and air in the stomach and intestine. If a feeding tube was passed it will be seen coiled up in the upper esophagus.

Treatment

Surgical repair of the esophagus is done quickly after the infant has been stabilized. Before the surgery, the infant is not fed by mouth, and care is taken to prevent the aspiration of secretions into the lungs.

Expectations (prognosis)

Early diagnosis is associated with a better outcome.

Complications

Calling your health care provider

This disorder is usually diagnosed shortly after the birth of an infant. Call your infant's health care provider if the infant regurgitates repeatedly after feedings, or if the infant develops breathing difficulties .

Prevention

The cause of this birth defect is unknown; therefore prevention is unknown. Prompt treatment is necessary to prevent life-threatening complications.