Esophageal atresia and tracheoesophageal fistula

Last reviewed: 1 Sep 2022
Last updated: 15 Oct 2021

Summary

Definition

History and exam

Key diagnostic factors

  • maternal history of polyhydramniosis
  • inability to swallow secretions
  • inability to pass a nasogastric tube
More key diagnostic factors

Other diagnostic factors

  • labored respiration
  • coughing
  • choking
  • VACTERL association
  • cyanosis
Other diagnostic factors

Risk factors

  • trisomy 18 and 21
  • family history
More risk factors

Diagnostic investigations

1st investigations to order

  • prenatal ultrasound
  • prenatal MRI
  • x-ray chest and abdomen
More 1st investigations to order

Investigations to consider

  • bronchoscopy
  • esophagoscopy
  • barium swallow
  • transthoracic echocardiogram
More investigations to consider

Treatment algorithm

ACUTE

type A

type B and D

type C

type E

Contributors

Authors

Alexander J. Bondoc, MD

Assistant Professor

UC Department of Surgery

UC Department of Pediatrics

Cincinnati Children's Hospital

Cincinnati

OH

Disclosures

AJB declares that he has no competing interests.

Aaron Garrison, MD

Assistant Professor

UC Department of Surgery

Cincinnati Children's Hospital

Cincinnati

OH

Disclosures

AG declares that he has no competing interests.

Daniel von Allmen, MD

Professor-Associate

University of Cincinnati

Department of Surgery

Cincinnati

OH

Disclosures

DVA is on the Board of Trustees for Cincinnati Children's Hospital Medical Center and the Medical Advisory Board for Bolder Surgical.

Acknowledgements

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

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

MI

Disclosures

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

PA

Disclosures

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

UK

Disclosures

LS declares that he has no competing interests.

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