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.

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