Tracheoesophageal fistula

From Wikipedia, the free encyclopedia

(Redirected from Tracheo-oesophageal fistula)
Jump to: navigation, search
Tracheoesophageal fistula
Classification & external resources
ICD-10 J95.0, Q39.1-Q39.2
ICD-9 530.84, 750.3
DiseasesDB 30034
eMedicine med/3416 
MeSH D014138

A tracheoesophageal fistula (TEF) is an abnormal connection (fistula) between the esophagus and the trachea. TEF is a common congenital abnormality, but when occurring late in life is usually the sequela of surgical procedures such as a laryngectomy.

Contents

Congenital TEF can arise due to failed fusion of the tracheoesophageal ridges during the third week of embryological development. [1]

It is often found in association with coloboma of the iris, various heart abnormalities, choanal atresia, retardation, genital defects, and ear abnormalities-- an association known as the CHARGE syndrome.

TEF is also part of the VACTERL association.

Fistulae between the trachea and esophagus in the newborn can be of diverse morphology and anatomical location,[2][3] however, various pediatric surgical publications have attempted a classification system comprised of the below specified types.

Type Description
Type C Proximal esophageal atresia (esophagus continuous with the mouth ending in a blind loop superior to the sternal angle) with a distal esophagus arising from the lower trachea or carina. (Most common, up to 90% of cases.)
Type A Proximal and distal esophageal bud--a normal esophagus with a missing mid-segment.
Type D Proximal esophageal termination on the lower trachea or carina with distal esophagus arising from the carina.
Type H A variant of type D: if the two segments of esophagus communicate, this is termed an H-type fistula due to its resemblance to the letter H.
Type B Proximal esophageal termination on the lower trachea with distal esophageal bud.

The letter codes are usually associated with the system used by Gross,[4] while number codes are usually associated with Vogt.[5]

(For the purposes of this discussion, proximal esophagus indicates normal esophageal tissue arising normally from the pharynx, and distal esophagus indicates normal esophageal tissue emptying into the proximal stomach.)

Tracheoesophageal fistula is suggested in a newborn by copious salivation associated with choking, coughing, and cyanosis coincident with the onset of feeding.

It is surgically corrected, with resection of any fistula and anastomosis of any discontinuous segments. Surgical repair is associated with complications, including

  • Stricture, due to gastric acid erosion of the shortened esophagus.
  • Leak of contents at the point of anastomosis.
  • Recurrence of fistula.

  1. ^ Esophageal Atresia and Tracheoesophageal Fistula - February 15, 1999 - American Academy of Family Physicians. Retrieved on 2007-11-11.
  2. ^ Spitz L (2007). "Oesophageal atresia". Orphanet journal of rare diseases 2: 24. doi:10.1186/1750-1172-2-24. PMID 17498283. 
  3. ^ Kovesi T, Rubin S (2004). "Long-term complications of congenital esophageal atresia and/or tracheoesophageal fistula". Chest 126 (3): 915–25. doi:10.1378/chest.126.3.915. PMID 15364774. 
  4. ^ Gross, RE. The surgery of infancy and chilhood. Philadelphia , WB Saunders; 1953.
  5. ^ Vogt EC. Congenital esophageal atresia. Am J of Roentgenol. 1929;22:463–465.

 This surgery article is a stub. You can help Wikipedia by expanding it.
v • d • e
Congenital malformations and deformations of digestive system (Q35-Q45, 749-751)
Tongue, mouth and pharynx Cleft lip and palate - Van der Woude syndrome - Ankyloglossia - Macroglossia - Pharyngeal pouch
Esophagus and upper alimentary tract Esophageal atresia - Tracheoesophageal fistula - Esophageal web - Pyloric stenosis - Hiatus hernia
Intestines Intestinal atresia (Duodenal atresia) - Imperforate anus - Meckel's diverticulum - Hirschsprung's disease - Intestinal malrotation - Persistent cloaca
Pancreas Annular pancreas - Accessory pancreas - Pancreas divisum
Other Choledochal cysts - Alagille syndrome
See also non-congenital (K20-K93, 530-579)
Retrieved from "http://en.wikipedia.org/wiki/Tracheoesophageal_fistula"
Advanced Search
Included Web Search Engines


Safe Search

close

Top Matching Results

Occasionally Search.com will highlight specialized results that are based on the context of your query. Examples of specialized results include specific links to news, images, or video.

Top Matching Results may highlight information from other Search.com pages, content from the CNET Network of sites, or third party content. The listings are based purely on relevance. Search.com does not receive payment for listings in this section but our partners that provide this data may get paid for listing these products.

Sponsored Links

This section contains paid listings which have been purchased by companies that want to have their sites appear for specific search terms and related content. These listings are administered, sorted and maintained by a third party and are not endorsed by Search.com.

Search Results

Search.com sends your search query to several search engines at one time and integrates the results into one list which has been sorted by relevance using Search.com's proprietary algorithm. You can customize the list of search engines included in your metasearch from the preferences.

The search engines that are used in your metasearch may allow companies to pay to have their Web sites included within the results. To view the Paid Inclusion policy for a specific search engine, please visit their Web site. Search.com does not accept payment or share revenue with any search engine partner for listings in this section.