TRACHEO-OESOPHAGEAL FISTULA

TRACHEO-OESOPHAGEAL FISTULA


TRACHEO- OESOPHAGEAL FISTULA (TOF)

  • Tracheo-oesophageal fistula is an abnormal connection between oesophagus & trachea.

Types-

Type A

  • Oesophageal atresia without TOF (8%)
  • Both segments communicate with trachea.

Type B

  • Oesophageal atresia with proximal TOF (1%)
  • Blind proximal segment of oesophagus connects with trachea by fistula.
  • Distal end is blind

Type C

  • Oesophageal atresia with distal TOF (84%)
  • Distal segment of oesophagus is connected with trachea by fistula.

Type D-

  • Oesophageal atresia with proximal & distal TOF.
  • Both ends are blind & no communication (3%)

Type E-

  • TOF without oesophageal atresia (4%)
  • H- type

Clinical features-

  • Drooling of saliva from mouth in newborn baby is a diagnostic feature.
  • Aspiration, cough & cyanosis
  • Associated with maternal hydroaminos.
  • Gastric distension

Investigations-

  • USG revels polyhydroaminos
  • MRI- confirms presence of oesophageal atresia/ TOF
  • Bronchoscopy- visualizes fistula (investigation of choice)

Treatment-

  • Right thoractomy
  • Feeding gastrotomy & oesophagotomy in Type I.

Exam Important

Types-

Type A

  • Oesophageal atresia without TOF (8%)
  • Both segments communicate with trachea.

Type B

  • Oesophageal atresia with proximal TOF (1%)
  • Blind proximal segment of oesophagus connects with trachea by fistula.
  • Distal end is blind

Type C

  • Oesophageal atresia with distal TOF (84%)
  • Distal segment of oesophagus is connected with trachea by fistula.

Type D-

  • Oesophageal atresia with proximal & distal TOF.
  • Both ends are blind & no communication (3%)

Type E-

  • TOF without oesophageal atresia (4%)
  • H- type

Clinical features-

  • Drooling of saliva from mouth in newborn baby is a diagnostic feature.
  • Aspiration, cough & cyanosis
  • Associated with maternal hydroaminos.
  • Gastric distension
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