Congenital tracheo oesophageal fistula

 

Congenital tracheo-esophageal fistula is a congenital pathological communication between the trachea and esophagus.

Pathology and types:

The types of esophageal atresia/tracheo-esophageal fistula can be divided into 

-Proximal atresia with distal fistula: 85%

-Isolated esophageal atresia: 8%

-lsolated fistula (H-type): 4%

-Double fistula with intervening atresia: 1%

-Proximal fistula with distal atresia: 1%

Investigations:

Plain radiograph:

-Demonstration of the nasogastric tube curled in the proximal esophagus in a child where the passage of the tube has been unsuccessful is usually sufficient for diagnosis. 

-The proximal esophageal stump may be distended with air (types A and C).

-The presence of air in the stomach and bowel in the setting of esophageal atresia implies that there is a distal fistula.

-Often the lungs demonstrate areas of consolidation/atelectasis due to recurrent aspiration.