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Esophageal atresia and tracheoesophageal fistula

Last reviewed: 6 Apr 2025
Last updated: 22 Nov 2024

Summary

Definition

History and exam

Key diagnostic factors

  • maternal history of polyhydramniosis
  • inability to swallow secretions
  • inability to pass a nasogastric tube
Full details

Other diagnostic factors

  • labored respiration
  • coughing
  • choking
  • VACTERL association
  • cyanosis
Full details

Risk factors

  • trisomy 18 and 21
  • family history
Full details

Diagnostic tests

1st tests to order

  • prenatal ultrasound
  • prenatal MRI
  • x-ray chest and abdomen
Full details

Tests to consider

  • bronchoscopy
  • esophagoscopy
  • barium swallow
  • transthoracic echocardiogram
Full details

Treatment algorithm

ACUTE

type A

type B and D

type C

type E

Contributors

Authors

Associate Professor

UC Department of Surgery

UC Department of Pediatrics

Cincinnati Children's Hospital

Cincinnati

OH

Disclosures

AJB declares that he has no competing interests.

Associate Professor

UC Department of Surgery

Cincinnati Children's Hospital

Cincinnati

OH

Disclosures

AG declares that he has no competing interests.

Professor-Associate

University of Cincinnati

Department of Surgery

Cincinnati

OH

Disclosures

DVA is an investor for GlobalCastMD.

Dr Alexander J. Bondoc would like to gratefully acknowledge Dr Steven S. Rothenberg, a previous contributor to this topic.

Disclosures

SSR declared that he had no competing interests.

Peer reviewers

Surgeon in Chief

Professor of Surgery

Department of Pediatric Surgery

Children's Hospital of Michigan

Wayne State University School of Medicine

Detroit

MI

Disclosures

MDK declares that he has no competing interests.

Clinical Director

Division Pediatric General and Thoracic Surgery

Children's Hospital of Pittsburgh of UPMC

Pittsburgh

PA

Disclosures

TDK declares that he has no competing interests.

Emeritus Nuffield Professor of Paediatric Surgery

Institute of Child Health

University College

London

UK

Disclosures

LS declares that he has no competing interests.

References

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Key articles

van Lennep M, Singendonk MMJ, Dall'Oglio L, et al. Oesophageal atresia. Nat Rev Dis Primers. 2019 Apr 18;5(1):26. Abstract

Slater BJ, Rothenberg SS. Tracheoesophageal fistula. Semin Pediatr Surg. 2016 Jun;25(3):176-8. Abstract

Krishnan U, Mousa H, Dall'Oglio L, et al. ESPGHAN-NASPGHAN guidelines for the evaluation and treatment of gastrointestinal and nutritional complications in children with esophageal atresia-tracheoesophageal fistula. J Pediatr Gastroenterol Nutr. 2016 Nov;63(5):550-70. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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