Materiały źródłowe

• #1 Tracheoesophageal Fistula and Esophageal Atresia symptoms | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/gastroenterology/tracheoesophageal-fistula/symptoms

  Symptoms of tracheoesophageal fistula and esophageal atresia vary greatly from one newborn to another. Symptoms can include: Coughing or choking while nursing or taking a bottle […] Frothing or drooling from the mouth […] Vomiting […] Difficulty breathing while feeding […] Blue-tinged skin while feeding […] An unusually rounded abdomen […] Failure to gain weight. Diagnosing and treating tracheoesophageal fistula and esophageal atresia as soon as possible is essential, not only for the babys ability to feed and thrive, but also because milk or formula can be inhaled, leading to aspiration pneumonia.

• #2 Esophageal Atresia and Tracheoesophageal Fistula (EA/TEF) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/esophageal-atresia-and-tracheoesophageal-fistula-eatef

  Esophageal atresia (EA) and tracheoesophageal fistula (TEF) are rare conditions that develop before birth. They often occur together and affect the development of the esophagus (food pipe), trachea (windpipe) or both. These conditions can be life-threatening and must be treated shortly after birth. […] For babies born with both esophageal atresia (EA) and tracheoesophageal fistula (TEF), symptoms appear almost immediately after birth. […] The most common EA and TEF symptoms include: Difficulty breathing, Coughing or choking when swallowing or trying to eat. […] Babies with esophageal atresia cannot swallow breastmilk, bottled milk or even their own saliva, and food cannot get to their stomach to be digested. […] In the most common type of esophageal atresia with tracheoesophageal fistula, there is a connection between the lower esophagus and the airway. This can be harmful to the baby’s lungs when stomach juices reflux or regurgitate through the connection.

• #2 Esophageal Atresia and Tracheoesophageal Fistula (EA/TEF) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/esophageal-atresia-and-tracheoesophageal-fistula-eatef

  In rare cases, a TEF may occur without EA. For these babies, it may take several weeks to diagnose the condition because TEF symptoms usually only appear as mild coughing or respiratory problems. […] Other symptoms of TEF and/or EA can include: Frothy, white bubbles coming from the mouth, Unable to successfully feed by mouth, Very round, full belly (from gas being trapped there), Bluish color to the skin, especially when the baby is eating, Clinician is unable to pass a tube from the baby’s mouth into their stomach.

• #3 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  Oesophageal atresia (OA) and tracheooesophageal fistula (TOF) has been a key domain of paediatric surgery since its early beginnings and continues to challenge specialists who care for these vulnerable children. […] The baby with OATOF classically presents with respiratory distress and feeding difficulties, choking, and frothing in the first few hours of life. […] Delivery should be planned at an obstetrical centre with ready access to a surgical unit. […] The risk of recurrence in subsequent pregnancies of nonsyndromal OATOF is 1%. […] The baby with OATOF classically presents with respiratory distress and feeding difficulties, choking, and frothing in the first few hours of life. […] Respiratory problems are common in children with OA and TOF. Severe tracheomalacia and bronchomalacia occur in 10-20% of infants.

• #3 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  A minority of infants will require aortopexy to stabilise the trachea and permit weaning from mechanical ventilation. […] Recurrent chest infections, bronchitis and pneumonia occur in up to two thirds of TOF survivors in the early years of life. […] Gastrooesophageal reflux is recorded in almost 50% of children, although it is universally present to a degree in all patients. […] This can lead to oesophagitis, stricture(s), nutritional and respiratory problems. […] Oesophageal dysmotility is an expected finding and can be shown on manometry in 75-100% of children after operative primary repair. […] Respiratory morbidity decreases in frequency and severity as the child reaches late adolescence.

• #4 Tracheoesophageal Fistula: Types, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/23395-tracheoesophageal-fistula

  Tracheoesophageal symptoms depend on whether EA is present, as well as TEF. Babies who are born with TEF but not EA usually dont show symptoms at birth. Over time, however, they may: […] Babies who have esophageal atresia with tracheoesophageal fistula usually exhibit symptoms immediately after delivery. The most common symptoms include: Coughing. Choking when trying to swallow. Breathing problems.

• #5 Tracheoesophageal Fistula and Esophageal Atresia – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/tracheoesophageal-fistula-and-esophageal-atresia

  Symptoms may include frothy, white bubbles in the mouth, coughing or choking while feeding, and other symptoms. […] The symptoms of TE fistula or esophageal atresia are usually noted very soon after birth. The following are the most common symptoms of TE fistula or esophageal atresia. However, each child may experience symptoms differently. Symptoms may include the following: Frothy, white bubbles in the mouth, coughing or choking when feeding, vomiting, blue color of the skin (cyanosis), especially when the baby is feeding, difficulty breathing, very round, full abdomen. […] Symptoms of TE fistula or esophageal atresia may resemble other conditions or medical problems. It is important to talk with your child’s medical team to receive the right diagnosis. […] Some children born with esophageal atresia have long-term problems. Swallowing food or liquids may be difficult due to problems with the normal movement of foods and liquids down the esophagus (peristalsis), and scarring that can occur in the esophagus after surgery as the wounds heal, which can partially block the passage of foods. About one-half of children who had esophageal atresia repaired will have problems with GERD, or gastrointestinal reflux disease. GERD causes acid to move up into the esophagus from the stomach. When acid moves from the stomach into the esophagus, it causes a burning or painful feeling known as heartburn. GERD can usually be treated with medications or by a minimally invasive surgical antireflux procedure known as a fundoplication.

• #6 Tracheoesophageal Fistula and Esophageal Atresia

  https://www.nationwidechildrens.org/conditions/health-library/tracheoesophageal-fistula-and-esophageal-atresia

  TE fistula is a birth defect. This means its a problem you are born with. […] 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. This means your babys esophagus doesnt 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 dont connect to each other. […] Since the esophagus is in 2 parts, liquid that your baby swallows doesnt pass as it should through the esophagus and reach the stomach. This means your baby can’t digest milk or other fluids. […] Your childs healthcare provider will often spot symptoms soon after your baby is born. Symptoms can happen a bit differently in each child. They can include: Frothy, white bubbles in the mouth, Coughing or choking when feeding, Vomiting, Blue color of the skin, especially when the baby is feeding, Trouble breathing, Very round, full stomach.

• #6 Tracheoesophageal Fistula and Esophageal Atresia

  https://www.nationwidechildrens.org/conditions/health-library/tracheoesophageal-fistula-and-esophageal-atresia

  The symptoms of these conditions may look like symptoms of other health problems. Your child must be diagnosed with this condition by their healthcare provider. […] Treatment will depend on your childs symptoms, age, and general health. It will also depend on how severe the condition is. If your child has 1 or both of these issues, they will need surgery. […] With esophageal atresia, the esophagus is in 2 parts. Liquid that your baby swallows doesnt pass normally through the esophagus and reach the stomach. Your baby can’t digest milk or other fluids. […] Even after surgery, children with these conditions may have trouble swallowing well.

• #7 Tracheoesophageal Fistula and Esophageal Atresia | Valley Children’s Healthcare

  https://www.valleychildrens.org/conditions/tracheoesophageal-fistula-and-esophageal-atresia

  Tracheoesophageal fistula is a connection between the esophagus and the trachea. […] TE fistula is a birth defect. This means it’s a problem you are 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. This means 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. This means your baby can’t digest milk or other fluids.

• #8 Esophageal Atresia With or Without Tracheoesophageal Fistula: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/935858-overview

  Esophageal atresia refers to a congenitally interrupted esophagus. One or more fistulae may be present between the anomalous esophagus and the trachea. The lack of esophageal patency prevents swallowing. In addition to preventing normal feeding, this problem may cause infants to aspirate and literally drown in their own saliva, which quickly overflows the upper pouch of the obstructed esophagus. If a tracheoesophageal fistula (TEF) is present, fluid (either saliva from above or gastric secretions from below) may flow directly into the tracheobronchial tree. […] The neonate with esophageal atresia cannot swallow and drools copious amounts of saliva. Aspiration of saliva or milk, if the baby is allowed to suckle, can lead to an aspiration pneumonitis. In a baby with esophageal atresia and a distal TEF, the lungs may be exposed to gastric secretions. Also, air from the trachea can pass down the distal fistula when the baby cries, strains, or receives ventilation. This condition can lead to an acute gastric perforation, which is often lethal.

• #9 Tracheoesophageal Fistula and Esophageal Atresia

  http://library.oumedicine.com/Search/90,P02018

  Your childs healthcare provider will often spot symptoms soon after your baby is born. Symptoms can happen a bit differently in each child. They can include: Frothy, white bubbles in the mouth, Coughing or choking when feeding, Vomiting, Blue color of the skin, especially when the baby is feeding, Trouble breathing, Very round, full stomach. […] The symptoms of these conditions may look like symptoms of other health problems. Your child must be diagnosed with this condition by their healthcare provider. […] Treatment will depend on your childs symptoms, age, and general health. It will also depend on how severe the condition is. If your child has 1 or both of these issues, they will need surgery. […] With a TE fistula, the connection between the esophagus and trachea is closed in surgery.

• #10 Tracheoesophageal Fistula and Esophageal Atresia – Seattle Children’s

  https://www.seattlechildrens.org/conditions/tef-and-ea/

  Symptoms of TEF/EA: Breathing problems and coughing or choking when your baby tries to swallow. The symptoms show up right after birth. This requires immediate attention with a specialty team. […] Symptoms of TEF only: Severe coughing or choking when your baby tries to swallow, usually after feeding. Some babies may have trouble breathing while feeding. If your baby has TEF alone, it may be weeks or months after birth before TEF is diagnosed as the cause of symptoms. […] Symptoms of EA only: Your baby is not swallowing their saliva, is drooling a lot or has foamy mucus in their mouth or nose. Most often, EA alone is diagnosed before birth or right after birth. This requires immediate attention with a pediatric specialty team.

• #11 Tracheoesophageal Fistula and Esophageal Atresia | Phoenix Children’s Hospital

  https://phoenixchildrens.org/specialties-conditions/tracheoesophageal-fistula-and-esophageal-atresia

  TE fistula is a birth defect. This means its a problem you are born with. […] 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. This means your babys esophagus doesnt 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 dont connect to each other. […] Since the esophagus is in 2 parts, liquid that your baby swallows doesnt pass as it should through the esophagus and reach the stomach. This means your baby can’t digest milk or other fluids. […] Your childs healthcare provider will often spot symptoms soon after your baby is born. Symptoms can happen a bit differently in each child. They can include: Frothy, white bubbles in the mouth, Coughing or choking when feeding, Vomiting, Blue color of the skin, especially when the baby is feeding, Trouble breathing, Very round, full stomach.

• #12 Tracheo-oesophageal fistula and oesophageal atresia – Don’t Forget the Bubbles

  https://dontforgetthebubbles.com/tracheo-oesophageal-fistula-and-oesophageal-atresia/

  Tracheo-oesophageal fistula (TOF) is a common congenital malformation involving a communication (fistula) between the trachea and oesophagus. It typically occurs with oesophageal atresia (OA), with the upper end of the oesophagus ending in a blind pouch. TOF/ OA is a relatively common congenital anomaly occurring in approximately 1:3000-4500 live births. […] Clinical presentation varies depending on the type of TOF and the presence (or absence) of oesophageal atresia. If OA is present (types A-D), infants are usually symptomatic immediately after birth with excessive secretions. This manifests as drooling, choking or coughing post-feeds, poor tolerance of feeds, and respiratory distress. […] If a fistula exists between the trachea and distal oesophagus (types C-E), they may have prominent abdominal distension as large volumes of air enter the trachea, fistula and stomach during infant crying. This distension reduces the ability of the lungs to expand, leading to atelectasis and respiratory compromise. Additionally, reflux of gastric contents through the fistula may cause chemical pneumonitis and aspiration pneumonia, further compromising respiratory function.

• #12 Tracheo-oesophageal fistula and oesophageal atresia – Don’t Forget the Bubbles

  https://dontforgetthebubbles.com/tracheo-oesophageal-fistula-and-oesophageal-atresia/

  Infants with H-type TOF may present at different ages depending on the size of the defect. If the fistula is large, infants will show signs of choking and coughing with feeds as milk is aspirated through the fistula into the trachea. If the fistula is small, they may be asymptomatic until after the newborn period. They typically have a prolonged history of mild respiratory distress associated with feeding, recurrent chest infections and failure to thrive.

• #13 Tracheal esophageal fistula and esophageal atresia | Children’s Wisconsin

  https://childrenswi.org/medical-care/fetal-concerns-center/conditions/infant-complications/tracheal-esophageal-fistula-and-esophageal-atresia

  A fistula is an abnormal connection and atresia means a blockage. An esophageal atresia is a blockage in the esophagus, which can occur with or without a fistula. […] The affects that TEF/EA will have on your baby depends on the type of TEF. If there is a closure in the upper esophagus, the baby will not be able to swallow saliva or food. The baby will have fine, frothy bubbles in the mouth and sometimes coming out the nose. Any attempt at feeding will result in choking, coughing and the formula will come back out because it has no place to go. If the infant aspirates (breaths foreign matter into the lungs), he or she may develop respiratory distress. […] A fistula may increase the chances of respiratory problems. If the fistula is from the upper pouch or is the H-type, symptoms may only be seen when the baby eats. With a fistula of the upper pouch, when the baby eats there may be severe respiratory symptoms. The baby may become blue and appear to choke because the formula can pass through the fistula, into the trachea and then into the lungs.

• #14 Congen Anom of the Dig Sys: Oesophageal Atresia/Tracheo-Oesophageal Fistula | NCBDDD | CDC

  https://archive.cdc.gov/www_cdc_gov/ncbddd/birthdefects/surveillancemanual/quick-reference-handbook/oesophageal-atresia-tracheo-fesophageal-fistula.html

  Oesophageal (esophageal) atresia is a congenital malformation characterized by the oesophagus ending in a blind pouch that does not connect to the stomach. Tracheo-oesophageal fistula (TEF or TOF) consists of a communication between the oesophagus and the trachea that is not normally present. Although it might occur alone, TEF is commonly associated with oesophageal atresia. […] Signs of oesophageal atresia at birth include vomiting immediately after feeding, excessive drooling or mucus, and, if TEF is present, respiratory distress. […] Because of the variability in symptoms, the diagnosis of TEF without oesophageal atresia may be delayed for weeks, months, or even years.

• #15 Esophageal Atresia and Tracheoesophageal Fistula – familydoctor.org

  https://familydoctor.org/condition/esophageal-atresia-and-tracheoesophageal-fistula/

  An esophageal atresia (EA) and a tracheoesophageal fistula (TEF) are 2 disorders of the digestive system. The condition affects babies. It starts while the mother is pregnant. This makes it a congenital defect. The 2 disorders often happen together. […] The main problems EA causes are with the digestive system. TEF usually causes breathing problems. Symptoms of EA/TEF include: Feeding problems upon birth, Frequent drooling or spitting up, Bubbly mucus in the mouth, Coughing, gagging, or choking when feeding, Bluish skin color when feeding, Difficulty breathing. […] Most babies with EA develop symptoms right after birth. For babies who have TEF but not EA, symptoms are mild and could take weeks to diagnose.

• #16 Esophageal atresia/tracheoesophageal fistula: MedlinePlus GeneticsLock

  https://medlineplus.gov/genetics/condition/esophageal-atresia-tracheoesophageal-fistula/

  Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a condition resulting from abnormal development before birth of the tube that carries food from the mouth to the stomach (the esophagus). […] In esophageal atresia (EA), the upper esophagus does not connect (atresia) to the lower esophagus and stomach. Almost 90 percent of babies born with esophageal atresia also have a tracheoesophageal fistula (TEF), in which the esophagus and the trachea are abnormally connected, allowing fluids from the esophagus to get into the airways and interfere with breathing. […] While EA/TEF arises during fetal development, it generally becomes apparent shortly after birth. Saliva, liquids fed to the infant, or digestive fluids may enter the windpipe through the tracheoesophageal fistula, leading to coughing, respiratory distress, and a bluish appearance of the skin or lips (cyanosis).

• #16 Esophageal atresia/tracheoesophageal fistula: MedlinePlus GeneticsLock

  https://medlineplus.gov/genetics/condition/esophageal-atresia-tracheoesophageal-fistula/

  Esophageal atresia blocks liquids fed to the infant from entering the stomach, so they are spit back up, sometimes along with fluids from the respiratory tract. EA/TEF is a life-threatening condition; affected babies generally require surgery to correct the malformation in order to allow feeding and prevent lung damage from repeated exposure to esophageal fluids.

• #17 Esophageal Atresia and Tracheoesophageal Fistula | Texas Children’s

  https://www.texaschildrens.org/content/conditions/esophageal-atresia-and-tracheoesophageal-fistula

  Esophageal atresia and tracheoesophageal fistula are birth defects that affect the esophagus (food tube) and the trachea (windpipe), causing breathing and digestive problems at birth. The defects occur when these tubes don’t form properly during fetal development. […] Babies born with these defects require surgery after birth. Without treatment, the condition can be life-threatening. […] In babies with esophageal atresia, the esophagus forms in two segments, an upper and lower segment, that aren’t connected. […] Because a gap exists between these two segments, nothing fed to the baby by mouth is able to reach the stomach and be digested. A baby with esophageal atresia may cough, choke or drool while feeding, or spit fluids back up. […] As a result of this connection, gastric juices can get into the trachea and reach the lungs, causing the infant to cough, choke and have difficulty breathing. Fluid in the lungs can also cause infections such as pneumonia. If the oxygen levels in the blood become affected, the baby’s skin or lips may turn bluish (known as cyanosis).

• #18 Tracheoesophageal Fistula: Causes, Symptoms, Diagnosis, Treatment

  https://www.healthline.com/health/tracheoesophageal-fistula

  The overwhelming majority of TEFs occur in newborns. Symptoms are usually present at birth or soon after. The condition can cause severe breathing and eating issues. Heres what you might notice in your baby: inability to swallow normally, breathing issues, large amount of drool or mucus, white, frothy bubbles in the mouth, aspiration of gastric juices, saliva, mucous, or other secretions into the lungs, causing breathing issues, gagging, coughing, choking, signs of low oxygen levels, which may include skin turning blue, labored breathing, and flared nostrils. […] In rare cases, adults may develop a TEF. Symptoms in adults may include: coughing, aspiration of fluids, fever, pneumonia, difficulty swallowing, coughing up blood, coughing that includes swallowing solid or liquid matter. […] If a TEF isn’t addressed promptly with surgical repair, it can become life threatening for an infant. This is because babies with a TEF have trouble feeding and breathing. If not corrected, the lungs can also become damaged from repeated exposure to gastric fluids. […] Because a TEF is life threatening if not treated promptly, a baby diagnosed with this condition will usually need to have surgery soon after birth.

• #19 Tracheoesophageal Fistula (TEF) and Esophageal Atresia (EA) – Children’s Hospital of Orange County

  https://choc.org/programs-services/pediatric-general-surgery/tracheoesophageal-fistula-esophageal-atresia/

  The symptoms of TE fistula or esophageal atresia can happen a bit differently in each child. They can include: Frothy, white bubbles in the mouth, Coughing or choking when feeding, Vomiting, Blue color of the skin, especially when the baby is feeding, Trouble breathing, Very round, full stomach. […] The symptoms of these conditions may look like symptoms of other health problems. […] When a baby with a TE fistula swallows, liquid such as milk and saliva 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 two 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. If left untreated, this could lead to malnutrition. […] Most children with these conditions have a good prognosis and will go on to eat and grow normally. […] Some children with esophageal atresia have long-term problems that range from mild to severe. It may be hard for them to swallow foods and liquids.

• #20 Oesophageal atresia and tracheo-oesophageal fistula

  https://www.nhs.uk/conditions/oesophageal-atresia/

  Oesophageal atresia is a rare birth defect that affects a baby’s oesophagus (the tube through which food passes from the mouth to the stomach). […] These defects mean the baby won’t be able to swallow safely, if at all. […] They could also develop life-threatening problems such as choking and pneumonia if not treated quickly, so surgery will usually be carried out within a few days of birth. […] Tests to check for the condition will be carried out after your baby is born, if they seem to be having problems swallowing or breathing. […] After surgery, your child will be kept in the intensive care unit and placed in an incubator. […] Contact the hospital or your GP if your child is choking or coughing on their feeds, has any difficulty swallowing or is failing to gain weight. […] But there’s a chance your child may experience some further problems, including: swallowing difficulties (dysphagia) […] Your child will be continuously monitored by specialists after their operation to pick up problems such as these and treat them early on. Some of these problems will improve as your child gets older.

• #21 Oesophageal Atresia | Doctor

  https://patient.info/doctor/oesophageal-atresia

  Diagnosis may be suspected antenatally because of polyhydramnios and an absent fetal stomach bubble detected on ultrasound. […] A baby with oesophageal atresia TOF classically presents with respiratory distress, choking, feeding difficulties and frothing in the first few hours after birth. […] Oesophageal atresia TOF should be considered whenever a baby develops feeding and respiratory difficulties in the first few days of life.

• #22 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/gastrointestinal-tract/esophageal-atresia

  Esophageal atresia may be suspected prenatally in only about 40% of cases because if there is an associated tracheoesophageal fistula (found in 80% of cases), the stomach may look normal. […] Survival is primarily dependent on gestation at delivery and the presence of other anomalies. For babies with an isolated tracheoesophageal fistula, born after 32 weeks’ gestation without aspiration pneumonitis, postoperative survival is 95%.

• #23 Oesophageal atresia and tracheo-oesophageal fistula | NHSGGC

  https://clinicalguidelines.scot.nhs.uk/ggc-paediatric-guidelines/ggc-paediatric-guidelines/neonatology/oesophageal-atresia-and-tracheo-oesophageal-fistula/

  Oesophageal atresia is a congenital abnormality where the oesophagus ends in a blind upper pouch. It can occur in isolation or there may be one or more fistulae between the abnormal oesophagus and the trachea (tracheo-oesophageal fistula). Babies born with OA/TOF need to have intensive neonatal care prior to corrective surgery, normally within days of birth. […] Postnatal presentation includes respiratory symptoms, frothing/ dribbling of saliva, coughing/choking during feeds, and inability to pass a nasogastric tube (NGT) into the stomach. […] If the X-ray confirms the diagnosis of oesophageal atresia, follow the guidelines for ongoing care. The infant also needs be examined for other associated abnormalities (including congenital cardiac disease and anorectal malformation). It is important that a departmental ECHO is performed preoperatively to exclude major congenital cardiac anomalies and determine the position of the aortic arch (determines incision site).

• #23 Oesophageal atresia and tracheo-oesophageal fistula | NHSGGC

  https://clinicalguidelines.scot.nhs.uk/ggc-paediatric-guidelines/ggc-paediatric-guidelines/neonatology/oesophageal-atresia-and-tracheo-oesophageal-fistula/

  The finding of a long-gap atresia may call for a delayed primary anastomosis and Replogle nursing for 6-8 weeks or longer, to allow the oesophagus time to lengthen. […] The baby will continue to be nursed head up to reduce the risk of gastric contents refluxing up to the anastomosis. Paralysis may be continued, especially with a tight repair, and ventilation continued for 4 to 7 days – with pain relief and sedation. The surgeon may also request that the infant be nursed supine with head flexed, to reduce tension on the suture line.

• #24 Esophageal Atresia and Tracheoesophageal Fistula: Signs, Causes & Treatment

  https://www.whattoexpect.com/first-year/tracheoesophageal-atresia-and-tracheoesophageal-fistula.aspx

  If a doctor suspects that a baby has EA and/or TEF, they’ll diagnose the problem by trying to insert a feeding tube through a baby’s nose or mouth. If the feeding tube isn’t able to reach a baby’s stomach, an X-ray will be ordered to confirm the EA and/or TEF diagnosis. In many cases, the conditions can also be detected via ultrasound during pregnancy.

• #25 Esophageal Atresia and Tracheoesophageal Fistula | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/0215/p910.html

  If esophageal atresia is suspected, a radiopaque 8 French (in preterm infants) or 10 French (in term infants) nasogastric or feeding tube should be passed through the nose to the stomach. In patients with atresia, the tube typically stops at 10 to 12 cm. […] Once a diagnosis of esophageal atresia is established, preparations should be made for surgical correction. Measures should be taken to reduce the risk of aspiration. […] Most neonates who undergo repair of esophageal atresia and tracheoesophageal fistula have some degree of esophageal dysmotility. […] Approximately one half of patients with surgically corrected esophageal atresia develop gastroesophageal reflux disease (GERD).

• #26 Esophageal Atresia and Tracheoesophageal Fistula – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/birth-defects-of-the-digestive-tract/esophageal-atresia-and-tracheoesophageal-fistula

  A newborn with esophageal atresia coughs, chokes, and drools after attempting to swallow while feeding. […] A tracheoesophageal fistula is dangerous because it allows swallowed food and saliva to travel through the fistula to the lungs, leading to coughing, choking, difficulty breathing, and possibly aspiration pneumonia (due to inhaling food or saliva). Food or fluid in the lungs may impair oxygenation of blood, leading to a bluish discoloration of the skin (cyanosis).

• #27 Esophageal Atresia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/21178-esophageal-atresia

  Esophageal atresia is a congenital malformation, which means something forms differently during fetal development, leaving a defect thats present at birth. […] The survival rate for babies who receive treatment and dont have other compromising conditions is near 100%. […] While most children recover well and grow to adulthood, some may have lingering side effects from the esophageal atresia and the surgery to fix it. […] Common long-term side effects include: Tracheomalacia, Swallowing difficulties, Gastroesophageal reflux disease (GERD). […] After surgical repair, your child may have some continued difficulties related to swallowing, breathing and respiratory infections, especially in the first few years.

• #28 Long-term esophageal complications – The Federation of Esophageal Atresia and Tracheo-Esophageal Fistula

  https://www.we-are-eat.org/tell-me-about-esophageal-atresia/long-term-esophageal-complications/

  The long-term esophageal and respiratory complications of esophageal atresia are inter-related: many of these complications increase the risk of the other complications. […] Eosinophilic Esophagitis is a disease of the esophagus where there are increased numbers of cells called eosinophils, in the walls of the esophagus. The most common symptom is difficulty swallowing, with food getting stuck in the esophagus while swallowing. Recent studies have suggested that about 17% of EA patients may have eosinophilic esophagitis. […] Difficulty swallowing, and choking on food, is common in people born with esophageal atresia. Hard and dry foods are often particularly difficult such as bread and meats such as steak and hot dogs. Food may be retained in the esophagus, then travel back into the mouth, and travel into the airways (known as aspiration). This can cause lung damage or recurrent pneumonias. Difficulty swallowing may also impair growth in children.

• #29 Tracheoesophageal Fistula – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK535376/

  The prognosis for isolated TEF is generally good. Infants with TEF and esophageal atresia have a more guarded prognosis, depending on the presence of associated abnormalities. In 1 report, 87% of patients with esophageal atresia or esophageal atresia and TEF survived, although 61% of early deaths were associated with cardiac and chromosomal anomalies. Mortality rates for esophageal atresia and TEF were greater for infants with associated cardiac disease (42% with versus 12% without). […] Respiratory complications are also common in children with TEF and esophageal atresia. Severe tracheomalacia and bronchomalacia occur in 10% to 20% of infants. Airway reactivity and instability can lead to life-threatening airway obstruction. […] Common complications after esophageal atresia and TEF repair in a series of 227 cases included anastomotic leak (16%), esophageal stricture (35%), and recurrent fistulae (3%). Esophageal stricture has been successfully managed with endoscopic balloon dilation.

• #30 Oesophageal atresia and Tracheo-oesophageal Fistula

  https://www.rch.org.au/transition/brochures/Oesophageal_atresia_and_Tracheo-oesophageal_Fistula/

  Oesophageal atresia (OA) is when the oesophagus does not connect to the stomach. […] A tracheo-oesophageal fistula (TOF) is when there is an abnormal connection between the trachea (windpipe) and the oesophagus (food pipe). […] OA/TOF needs to be repaired with surgery, which usually occurs in the first few days of life. […] Anyone who has had an OA/TOF will need to be monitored by a gastroenterologist every few years, even if they have no problems after surgery. […] You will need regular gastroscopies to check your oesophagus for any changes. […] Common problems include reflux, breathing and swallowing problems see your doctor if you experience any of these.

• #31 Oesophageal atresia and tracheo-oesophageal fistula – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/760

  Oesophageal atresia and tracheo-oesophageal fistula occurs in 1 of every 2500 to 4000 live births. […] There are no known predisposing factors; however, the condition often presents with other congenital anomalies, including VACTERL complex (vertebral defects, anorectal anomalies, cardiac defects, tracheo-oesophageal abnormalities, radial and renal abnormalities, and limb anomalies). […] Patients may have long-term complications, such as GORD, tracheomalacia, and chronic respiratory infections. […] Key diagnostic factors include inability to swallow secretions and inability to pass a nasogastric tube. […] Other diagnostic factors include laboured respiration, coughing, choking, and cyanosis.

• #32 Esophageal atresia and tracheoesophageal fistula – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/760

  Esophageal atresia and tracheoesophageal fistula occurs in 1 of every 2500 to 4000 live births. […] There are no known predisposing factors; however, the condition often presents with other congenital anomalies, including VACTERL complex (vertebral defects, anorectal anomalies, cardiac defects, tracheoesophageal abnormalities, radial and renal abnormalities, and limb anomalies). […] Patients may have long-term complications, such as GERD, tracheomalacia, and chronic respiratory infections. […] Key diagnostic factors include maternal history of polyhydramniosis, inability to swallow secretions, and inability to pass a nasogastric tube. […] Other diagnostic factors include labored respiration, coughing, choking, VACTERL association, and cyanosis.

• #33 Congenital tracheo-esophageal fistula | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/congenital-tracheo-esophageal-fistula?lang=us

  Clinical presentation is similar for all types except for type E (H-type). […] The diagnosis is usually made in the neonate, as they experience feeding difficulties and respiratory compromise due to repeated aspiration. In cases where esophageal atresia is present (i.e. all but H-type), attempts at passing a nasogastric tube will not be successful. […] Prognosis is often most affected by the presence of associated congenital chromosomal or cardiac anomalies. For example in one study (albeit from 1979) the mortality for infants with just esophageal atresia / tracheo-esophageal fistula was 23% vs 79% in those with associated cardiac anomalies.

• #34 Tracheoesophageal Fistula: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/186735-overview

  Most patients with TEFs are diagnosed immediately following birth or during infancy. TEFs are often associated with life-threatening complications, so they are usually diagnosed in the neonatal period. In rare cases, patients with a congenital TEF may present in adulthood. […] Approximately 17-70% of children with tracheoesophageal fistulas (TEFs) have associated developmental anomalies. These anomalies include Down syndrome, duodenal atresia, and cardiovascular defects. […] The survival rate in healthy infants who undergo surgical repair for a congenital tracheoesophageal fistula (TEF) may be 100%. In groups of infants who have comorbidities or who are not fit enough for early repair, the survival rate is 80-95%. […] Patients may develop morbidities following TEF repair, including tracheomalacia, esophageal dysmotility, gastroesophageal reflux, and dysphagia. […] Congenital and acquired TEFs are associated with multiple complications, including recurrent pneumonia, acute lung injury, acute respiratory distress syndrome, lung abscess, poor nutrition, bronchiectasis from recurrent aspiration, respiratory failure, and death.

• #35 Oesophageal atresia and/or tracheo-oesophageal fistula (OA/TOF) factsheet | The Sydney Children’s Hospitals Network

  https://www.schn.health.nsw.gov.au/oesophageal-atresia-andor-tracheo-oesophageal-fistula-oatof-factsheet

  Oesophageal atresia is a condition where the oesophagus doesn’t develop properly, preventing food from reaching the stomach, while tracheo-oesophageal fistula is an abnormal connection between the trachea and oesophagus that causes breathing and swallowing issues. […] OA/TOF symptoms usually appear right after birth, including: difficulty breathing, coughing or choking when feeding, frothy white bubbles around the mouth, vomiting, a swollen, round belly from trapped gas, bluish skin, especially during feeding. […] If a baby only has TOF without OA, symptoms like coughing and mild breathing problems may be less severe. […] OA/TOF may be detected before birth with an ultrasound but is usually diagnosed after birth. Your doctor or midwife might suspect OA/TOF if your baby shows certain symptoms or a feeding tube cannot be passed into their stomach.

• #35 Oesophageal atresia and/or tracheo-oesophageal fistula (OA/TOF) factsheet | The Sydney Children’s Hospitals Network

  https://www.schn.health.nsw.gov.au/oesophageal-atresia-andor-tracheo-oesophageal-fistula-oatof-factsheet

  After surgery, your baby will be moved to the neonatal intensive care unit (NICU) for breathing support, monitoring, and pain relief. […] Babies born with OA/TOF who have no other associated health issues have an excellent outlook. […] Children with OA/TOF often have trouble feeding, but this usually gets better as they grow. […] In some cases, the oesophagus can become narrow where it was joined together. This is called a stricture. […] Children with OA/TOF may develop gastro-oesophageal reflux disease (GERD), where stomach contents flow back into the oesophagus. […] Children with OA/TOF are at risk of developing allergic inflammation of the oesophagus. This is called Eosinophilic Esophagitis (EoE). […] Children with OA/TOF may also have tracheomalacia. This is a floppy windpipe caused by underdeveloped cartilage. […] Children with OA/TOF may have frequent colds or pneumonia due to a weak windpipe that makes it hard to clear mucus.

• #36 Oesophageal atresia (OA) and tracheo-oesophageal fistula (TOF) in children | CUH

  https://www.cuh.nhs.uk/patient-information/oesophageal-atresia-oa-and-tracheo-oesophageal-fistula-tof-in-children/

  Sometimes babies can have breathing difficulties and will need a breathing tube and help with their breathing from a ventilator. […] Your baby will also have a special tube called a replogle tube passed through their nose or mouth into their oesophagus. This tube will allow the nurses caring for your baby to clear out the saliva that your baby cannot swallow. […] After the operation your baby will be connected to monitors that measure their heart rate, oxygen levels and temperature. […] Children born with OA / TOF very often have a very characteristic barking cough commonly referred to as the TOF cough. This loud, barking cough is caused by floppiness (tracheomalacia) of the trachea (windpipe). […] Some babies with OA / TOF can experience periods when it appears that they are finding it hard to breathe.

• #36 Oesophageal atresia (OA) and tracheo-oesophageal fistula (TOF) in children | CUH

  https://www.cuh.nhs.uk/patient-information/oesophageal-atresia-oa-and-tracheo-oesophageal-fistula-tof-in-children/

  Swallowing problems could occur due to the oesophagus narrowing (called oesophageal stricture) where it was repaired. […] Some children who have had OA / TOF will develop a problem with gastro-oesophageal reflux (GOR) when they are older. In GOR the contents of the stomach flow back up the oesophagus causing irritation and pain. […] You should call the surgical nurse specialist team at the hospital if your baby shows any of the following: Coughing or choking when feeding, Difficulty in swallowing saliva or feeds including taking longer than usual to take a feed, Is failing to gain weight.

• #37 After your child has had oesophageal atresia and/or tracheo-oesophageal fistula repair | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/after-your-child-has-had-oesophageal-atresia-andor-tracheo-oesophageal-fistula-repair/

  In extreme cases, a child may have near death episodes where they seem to be choking and unable to breathe. […] Children who have had OA/TOF repair can develop a distinctive cough, often referred to as a TOF cough. […] Narrowing can happen when scars or strictures develop following surgery to the oesophagus. […] The narrowed oesophagus can cause additional problems with food with bits or lumps, or hard foods that are not completed chewed before swallowing. […] Children who have had OA/TOF repair will carry on coming back to GOSH regularly throughout childhood and adolescence.

• #38 Oesophageal atresia and/or tracheo-oesophageal fistula (OA/TOF) factsheet | The Sydney Children’s Hospitals Network

  https://www.schn.health.nsw.gov.au/oatof-oesophageal-atresia-andor-tracheo-oesophageal-fistula-factsheet

  After surgery, your baby will be moved to the neonatal intensive care unit (NICU) for breathing support, monitoring, and pain relief. […] Babies born with OA/TOF who have no other associated health issues have an excellent outlook. This means they will usually grow well and lead active, healthy lives. […] Children with OA/TOF often have trouble feeding, but this usually gets better as they grow. […] In some cases, the oesophagus can become narrow where it was joined together. This is called a stricture. […] Children with OA/TOF may develop gastro-oesophageal reflux disease (GERD), where stomach contents flow back into the oesophagus. […] Children with OA/TOF may also have tracheomalacia. This is a floppy windpipe caused by underdeveloped cartilage. […] Children with OA/TOF may have frequent colds or pneumonia due to a weak windpipe that makes it hard to clear mucus.

• #39 Oesophageal atresia with tracheo-oesophageal fistula | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/oesophageal-atresia-tracheo-oesophageal-fistula/

  They are both repaired in an operation, which lasts between two and three hours. […] No. OA and TOF always require treatment, to enable your baby to feed. […] The operation is carried out while your child is under general anaesthetic. […] All surgery carries a small risk of bleeding during or after the operation. […] Your baby will go to the intensive care unit to recover. […] If the OA and TOF occur on their own, with no other associated problems, the outlook for children who have them is good, with the majority growing up to live normal lives. […] Chest problems can occur, which are sometimes serious enough to need a stay in hospital. […] Feeding problems may also occur due to the oesophagus narrowing where it was originally repaired (strictures). […] Some children who have had OA and TOF develop a problem with gastro-oesophageal reflux when they are older. […] Weaning onto solid foods can also be more problematic for children who have had OA and TOF.

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