Summary
Definition
History and exam
Key diagnostic factors
- maternal history of polyhydramniosis
- inability to swallow secretions
- inability to pass a nasogastric tube
Other diagnostic factors
- labored respiration
- coughing
- choking
- VACTERL association
- cyanosis
Risk factors
- trisomy 18 and 21
- family history
Diagnostic tests
1st tests to order
- prenatal ultrasound
- prenatal MRI
- x-ray chest and abdomen
Tests to consider
- bronchoscopy
- esophagoscopy
- barium swallow
- transthoracic echocardiogram
Treatment algorithm
type A
type B and D
type C
type E
Contributors
Authors
Alexander J. Bondoc, MD
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.
Aaron Garrison, MD
Associate 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 an investor for GlobalCastMD.
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.
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.
References
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.
Differentials
- Laryngeal cleft
More DifferentialsGuidelines
- Oesophageal atresia/tracheoesophageal fistula
More Guidelines
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