Tracheoesophageal fistula – Clinical features, Diagnosis and Management

Tracheo esophageal fistula refers to an abnormal connection between the trachea and the esophagus. It is associated with polyhydramnios in mother and single umbilical artery in the newborn.

Clinical features:

  • Frothy discharge from baby mouth, drooling of saliva, aspiration, choking, cyanosis
  • Types – A, B, C, D, H
  • Most common – C type (85%) followed by A type

Complications:

  • Pneumonia
  • Gastro esophageal reflux disease
  • Atelectasis

Diagnosis:

  • 8 or 10 F size orogastric tube cannot be passed into stomach
  • Xray after instillation of air

Management:

  • Maintenance of upright posture
  • Frequent suction of esophageal pouch
  • Intravenous fluid administration
  • Antibiotics
  • Surgical correction should be done as soon as possible

Prognostic factors:

  • Early diagnosis
  • Fetal maturity
  • Development of pneumonitis
  • Presence of associated anomalies
  • Surgeon’s competence

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