Esophageal Atresia and Tracheoesophageal Fistula

The esophagus is a tube that leads from the throat to the stomach, and the trachea is a completely separate tube that leads from the throat to the windpipe and lungs. Tracheoesophageal fistula (TEF) occurs when there is a connection between these two tubes, and esophageal atresia occurs when the esophagus is split into two segments that do not connect as they should.

TEF and esophageal atresia are both birth defects. In the uterus, the trachea and the esophagus begin developing as one single tube. At about four to eight weeks after conception, a wall forms between the fetus’s esophagus and trachea to separate them into two distinct tubes. If this wall does not form properly, TEF and/or esophageal atresia can occur. These conditions are not thought to be inherited, but they often appear alongside other birth defects.

Symptoms and treatment of esophageal atresia and TEF

Esophageal atresia and TEF often occur concurrently. Symptoms for both conditions are usually noted very soon after birth and may include frothy white bubbles in the mouth, coughing or choking when feeding, vomiting, blue color to the skin, difficulty breathing, and a full, round abdomen. In TEF, liquid can find its way into the baby’s lungs, which can cause pneumonia and other problems. In esophageal atresia, food cannot reach the baby’s stomach, so nutrients from food cannot be digested.

At the Esophageal Disorders Clinic, we offer a minimally invasive, thoracoscopic approach to treatment that minimizes pain and scarring. Thoracoscopic approaches using a 3 to 5 mm incision can now be used to completely repair the defect.

After TEF repair, esophageal strictures are common. Traditionally, x-rays were the most common tool used to diagnose the condition, but the Stanford Medicine Children’s Health Esophageal Disorders Clinic often uses EndoFlip technology to diagnose and treat the condition, saving your child a dose of radiation. Our esophageal physicians are helping to design a 10 mm EsoFlip system to treat our smallest patients.