Esophageal Atresia and Tracheo-Esophageal Fistula

• ● Atresia means close, fistula means open.

  ● Esophageal atresia is when esophagus ends in a blind pouch, with no entry route to stomach.

  ● Tracheoesophageal fistula is an open connection between esophagus and trachea.

  These two birth defects often appear together resulting from an abnormal intrauterine development. It is not inherited; however, they are often seen when babies have other birth defects such as trisomy 21 (down syndrome), diaphragmatic hernia and some congenital heart diseases.
• ASSESSMENT

  I. ESOPHAGEAL ATRESIA

  Inability to pass a gastric tube.

  2. Increased drooling and salivation.

  3. Immediate regurgitation of undigested formula and milk when fed.

  II. TRACHEOESOPHAGEAL FISTULA

  1. Normal swallowing, but some food or mucus crosses fistula, causing choking and intermittent cyanosis (or aspiration).

  2. Distended abdomen from inhaled air crossing fistula into stomach.

  3. Aspiration pneumonia from reflux of gastric secretions into trachea
• MANAGEMENT

  PALLIATIVE

  ● Surgery will fix the problem, but while awaiting for the repair, interventions are focused on ensuring feeding such as gastrostomy and prevention of aspiration which is esophagostomy.

  1. Gastrostomy for feeding.

  B. Esophagostomy to drain secretions.
• 2. CORRECTIVE

  1. End-to-end anastomosis to restore normal anatomy.

  ● which connects the normal part together

  B. Colon transplant for defects where there is insufficient tissue for an end-to-end anastomosis.

  ● a part of the child’s colon will be used to connect