Tracheoesophageal Fistula
Tracheoesophageal fistula, is a fairly common congenital disorders. Tracheoesophageal fistula is an abnormal connection in one or more places between the esophagus (the tube that leads from the throat to the stomach) and the trachea (the tube that leads from the throat to the windpipe and lungs). A fistula is a connection between two tubes. The breathing tube that connects the nose and mouth with the lungs is called the trachea. The esophagus is the swallowing tube. The breathing tube and the swallowing tube aren't supposed to be connected. But when a child has a tracheoesophageal fistula, the fistula connects the two tubes. This means that food or milk in the stomach can get into the lungs. This can cause breathing problems and even pneumonia. TE(Tracheoesophageal) fistula is a birth defect, which is an abnormality that occurs as a fetus is forming in the mother's uterus.When a baby with a TE fistula swallows, the liquid can pass through the abnormal connection between the esophagus and the trachea. When this happens, liquid gets into the baby's lungs.
TE(Tracheoesophageal) fistula often occurs with another birth defect known as esophageal atresia. The esophagus is a tube that leads from the throat to the stomach. With esophageal atresia, the esophagus does not form properly while the fetus is developing before birth, resulting in two segments; one part that connects to the throat, and the other part that connects to the stomach. However, the two segments do not connect to each other. Since the esophagus is in two segments, liquid that a baby swallows cannot pass normally through the esophagus and reach the stomach. Milk and other fluids cannot be digested if the esophagus does not connect to the stomach. If a TE fistula is also present, liquid that a baby swallows can pass through the connection between the esophagus and the trachea and go into the lungs.This can cause pneumonia.
Causes of Tracheoesophageal Fistula
Common causes of Tracheoesophageal Fistula
- Low birth weight.
- Anesthesia.
- Fetus.
- Tracheomalacia.
- Diverticula at the myotomy site
- Pulmonary complications.
- Dyspepsia
- Anastomotic dehiscence.
- Esophageal stenosis.
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- Failure to thrive
- Chest wall deformities,
- Scoliosis.
Symptoms of Tracheoesophageal Fistula
Common symptoms of Tracheoesophageal Fistula
- Frothy white bubbles in the mouth.
- cough.
- vomiting.
- blue color of the skin, especially when the baby is feeding.
- Difficulty breathing.
- Very round, full abdomen.
- Swallowing difficulties.
Treatment of Tracheoesophageal Fistula
Common Treatment of Tracheoesophageal Fistula
- Tracheoesophageal fistula and esophageal atresia can usually be corrected surgically. If the two parts of the esophagus are too short, further surgery may be needed and a gastrostomy tube may be temporarily used for feedings.
- Treatment of malignant TEFs must be individualized, and the treatment should be instituted promptly.The therapy is generally palliative. Palliation consists of relief of obstruction and diversion of contamination from the respiratory tract.
- If sepsis or pulmonary infection is suspected, broad-spectrum antibiotics (such as ampicillin plus gentamicin) should be administered.
- Surgical repair is delayed in infants with low birth weight, pneumonia or other major anomalies.Premature low-birth-weight infants and infants with major concomitant malformations are typically treated with parenteral nutrition, gastrostomy and upper pouch suction until they are appropriate surgical candidates.
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