Esophageal atresia and tracheoesophageal fistula

Visão geral 
Teoria 
Diagnóstico 
Tratamento 
ACOMPANHAMENTO 
Recursos 

Conectar-se ou assinar para acessar todo o BMJ Best Practice

Última revisão: 20 Aug 2025

Última atualização: 22 Nov 2024

Esophageal atresia and tracheoesophageal fistula occurs in 1 of every 2500 to 4000 live births.

There are no known predisposing factors; however, the condition often presents with other congenital anomalies, including VACTERL complex (vertebral defects, anorectal anomalies, cardiac defects, tracheoesophageal abnormalities, radial and renal abnormalities, and limb anomalies).

Surgical intervention is required as a newborn. While repair is traditionally done via an open thoracotomy, thoracoscopic repair is safe and effective.

Patients may have long-term complications, such as GERD, tracheomalacia, and chronic respiratory infections.

Definição

Esophageal atresia (EA) and tracheoesophageal fistula (TEF) are congenital malformations that result from the defective separation of the common embryonic precursor to both the esophagus and trachea. The most common type is a blind-ending upper esophageal pouch with a fistulous connection between the distal esophageal segment and the trachea.

História e exame físico

Principais fatores diagnósticos

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

Detalhes completos

Outros fatores diagnósticos

labored respiration
coughing
choking
VACTERL association
cyanosis

Detalhes completos

Fatores de risco

trisomy 18 and 21
family history

Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

prenatal ultrasound
prenatal MRI
x-ray chest and abdomen

Detalhes completos

Investigações a serem consideradas

bronchoscopy
esophagoscopy
barium swallow
transthoracic echocardiogram

Detalhes completos

Algoritmo de tratamento

AGUDA

type A

type B and D

type C

type E

Colaboradores

Autores

Alexander J. Bondoc, MD

Associate Professor

UC Department of Surgery

UC Department of Pediatrics

Cincinnati Children's Hospital

Cincinnati

Declarações

AJB declares that he has no competing interests.

Aaron Garrison, MD

Associate Professor

UC Department of Surgery

Cincinnati Children's Hospital

Cincinnati

Declarações

AG declares that he has no competing interests.

Daniel von Allmen, MD

Professor-Associate

University of Cincinnati

Department of Surgery

Cincinnati

Declarações

DVA is an investor for GlobalCastMD.

Agradecimentos

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

Declarações

SSR declared that he had no competing interests.

Revisores

Michael D. Klein, MD, FACS, FAAP

Surgeon in Chief

Professor of Surgery

Department of Pediatric Surgery

Children's Hospital of Michigan

Wayne State University School of Medicine

Detroit

Declarações

MDK declares that he has no competing interests.

Timothy D. Kane, MD

Clinical Director

Division Pediatric General and Thoracic Surgery

Children's Hospital of Pittsburgh of UPMC

Pittsburgh

Declarações

TDK declares that he has no competing interests.

Lewis Spitz, MBChB, PhD, FRCS, MD, FRCPCH, FAAP, FCS

Emeritus Nuffield Professor of Paediatric Surgery

Institute of Child Health

University College

London

Declarações

LS declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

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

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

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. Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.

Diagnósticos diferenciais
- Laryngeal cleft
Mais Diagnósticos diferenciais
Diretrizes
- Oesophageal atresia/tracheoesophageal fistula
Mais Diretrizes
Conectar-se ou assinar para acessar todo o BMJ Best Practice

O uso deste conteúdo está sujeito ao nosso aviso legal

Esophageal atresia and tracheoesophageal fistula

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

Outros fatores diagnósticos

Fatores de risco

Investigações diagnósticas

Primeiras investigações a serem solicitadas

Investigações a serem consideradas

Algoritmo de tratamento

type A

type B and D

type C

type E

Colaboradores

Autores

Alexander J. Bondoc, MD

Declarações

Aaron Garrison, MD

Declarações

Daniel von Allmen, MD

Declarações

Agradecimentos

Declarações

Revisores

Michael D. Klein, MD, FACS, FAAP

Declarações

Timothy D. Kane, MD

Declarações

Lewis Spitz, MBChB, PhD, FRCS, MD, FRCPCH, FAAP, FCS

Declarações

Peer reviewer acknowledgements

Disclosures

Referências

Principais artigos

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.

Diagnósticos diferenciais

Diretrizes

Conectar-se ou assinar para acessar todo o BMJ Best Practice

Conectar-se ou assinar para acessar todo o BMJ Best Practice

Conectar-se para acessar todo o BMJ Best Practice