Tracheoesophageal fistula is a connection between the esophagus and the trachea. The esophagus is the tube that connects the throat to the stomach. The trachea is the tube that connects the throat to the windpipe and lungs. Normally, the esophagus and trachea are two tubes that are not connected. This issue is also called TE fistula or TEF. It can happen in one or more places.
TE fistula is a birth defect. This means it’s a problem your child was born with. It happened when your baby was forming during pregnancy.
When a baby with a TE fistula swallows, liquid can pass through the connection between the esophagus and trachea. When this happens, liquid gets into your baby's lungs. This can cause pneumonia and other problems.
TE fistula often happens with another birth defect called esophageal atresia. In this issue, your baby’s esophagus doesn’t form well during pregnancy. It forms in 2 parts instead of 1. One part connects to the throat. The other part connects to the stomach. But the 2 parts don’t connect to each other.
Since the esophagus is in 2 parts, liquid that your baby swallows doesn’t pass as it should through the esophagus and reach the stomach. Your baby cannot digest milk or other fluids.
As a baby is growing in pregnancy, organ systems are forming. The trachea and the esophagus start forming as 1 tube. At 4 to 8 weeks of pregnancy, a wall forms between the esophagus and trachea. This separates them into 2 tubes. TE fistula and esophageal atresia happen when this wall doesn’t form as it should.
Having the following factors can raise your baby’s risk for these issues:
Up to one half of babies with TE fistula or esophageal atresia also have another birth defect.
Your child’s healthcare provider will often spot symptoms soon after your baby is born. Symptoms can happen a bit differently in each child. They can include:
Your baby may also have other birth defects.
The symptoms of these conditions may look like symptoms of other health problems. Your child’s healthcare provider must diagnose him or her with this condition.
Your child’s healthcare provider will ask about your child’s health history. He or she will also give your child an exam.
Your child may need an X-ray of his or her chest and belly. For this test, the healthcare provider will put a small tube into your child's mouth or nose. It will be guided into the esophagus. With esophageal atresia, the tube often cannot go very far into the esophagus. The tube's position can be seen with the X-ray. This can help your child’s healthcare provider diagnose the condition.
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. If your child has one or both of these issues, he or she will need surgery.
With a TE fistula, the connection between the esophagus and trachea is closed in surgery.
Sometimes children with esophageal atresia need more than one surgery. This depends on how close the 2 tubes are to each other. Your baby's surgeon and healthcare team will decide when your baby should have the surgeries.
When a baby with a TE fistula swallows, liquid can pass through the connection between the esophagus and trachea. This can cause liquid to get into your baby's lungs. This can lead to pneumonia and other problems.
With esophageal atresia, the esophagus is in 2 parts. Liquid that your baby swallows doesn’t pass normally through the esophagus and reach the stomach. Your baby cannot digest milk or other fluids.
Children who had surgery for a TE fistula may develop scar tissue. This can make swallowing tricky. Your child may need another surgery to open the scar tissue.
Some children with esophageal atresia have long-term problems. It may be hard for them to swallow foods and liquids. This may be because of the following:
Some children may need a special test to widen a narrowed esophagus. Your child’s healthcare provider may do this while your child is under general anesthesia. Other children may need another surgery. Your child’s surgeon will open up the esophagus so food can pass to the stomach.
About one half of children who had surgery for esophageal atresia will develop gastrointestinal reflux disease (GERD). GERD causes acid to move up into the esophagus from the stomach. This causes a burning or painful feeling called heartburn. GERD can often be managed with medicines.
Work with your child’s healthcare team to create a care plan for your child. This will help your child grow and develop well.
Before surgery, call your child’s healthcare provider right away if your child has trouble breathing or breathes liquid into his or her lungs.
After surgery, call your child’s healthcare provider if your child has trouble swallowing or persistent vomiting, or isn't gaining weight.
Tips to help you get the most from a visit to your child’s healthcare provider:
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