Tracheoesophageal Fistula

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KEY POINTS

• A tracheoesophageal fistula is an opening between your child’s trachea and esophagus. The esophagus and the trachea are next to each other in the back of the throat and chest, but normally they are not connected.
• The treatment for tracheoesophageal fistula is surgery to close the opening. At the same time, your child’s healthcare provider may repair his esophagus by attaching it to his stomach. This condition is called esophageal atresia. Your child may need more than one surgery, and he may need a feeding tube for nutrition while he heals or awaits more surgery.
• Follow the full course of treatment prescribed by your child’s healthcare provider. Ask your child’s provider how to take care of your child at home.

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What is a tracheoesophageal fistula?

A tracheoesophageal fistula is an opening between your child’s trachea and esophagus. The trachea is your child’s windpipe. The windpipe is the airway that leads from the throat to the lungs. The esophagus is the tube that carries food from your child’s throat to his stomach. The esophagus and the trachea are next to each other in the back of the throat and chest, but normally they are not connected.

This condition is usually found right after birth. It usually is seen with another condition called esophageal atresia. Esophageal atresia means that your child’s esophagus is not connected to his stomach as it should be.

What is the cause?

Most of the time, the cause of tracheoesophageal fistula and esophageal atresia is not known. They are called congenital birth defects, which means that the baby has the conditions at birth. Sometimes babies with tracheoesophageal fistula and esophageal atresia also have other problems with the heart, the bowel, the muscles and bones, or the urinary tract. This condition affects both boys and girls.

What are the symptoms?

Your child’s symptoms may include:

• Problems with feeding including coughing or choking during or after swallowing
• Noisy breathing

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and examine him. Tests may include:

• Passing a small tube into your child’s esophagus that can be seen on X-ray
• Chest X-ray
• Belly X-ray
• Ultrasound, which uses sound waves to show pictures of the esophagus
• CT scan
• Bronchoscopy, which uses a flexible, lighted tube passed through your child’s mouth and down into the lungs to see abnormal areas

How is it treated?

The treatment is surgery. At the same time, your child’s healthcare provider may repair his esophagus by attaching it to his stomach, which is to fix the esophageal atresia. Your child may need more than one surgery, and he may need a feeding tube for nutrition while he heals or waits for more surgery.

How can I take care of my child?

Follow the full course of treatment prescribed by your child’s healthcare provider.

Ask your child’s provider:

• How and when you will get your child’s test results
• If there are activities your child should avoid and when he can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.