Paper
Tracheoesphageal Fistula Smith
Clinical IV
January 30, 2013
PATHOPHYSIOLOGY
In a 4- to 6-week-old embryo, the caudal part of the foregut forms a ventral diverticulum that evolves into the trachea. The longitudinal tracheoesophageal fold fuses to form a septum that divides the foregut into a ventral laryngotracheal tube and a dorsal esophagus. The posterior deviation of the tracheoesophageal septum causes incomplete separation of the esophagus from the laryngotracheal tube and results in a TEF. (Medscape 2013)
INCIDENCE
Esophageal atresia is a congenital defect, which means it occurs before birth. Other types of esophageal atresia involve narrowing of the esophagus, and may also be associated with other birth defects. Esophageal atresia occurs in about 1 out of 4,000 births. CAUSES There are several types. In most cases, the upper esophagus ends and does not connect with the lower esophagus and stomach. The top end of the lower esophagus connects to the windpipe. This connection is called a tracheoesophageal fistula (TEF). Some babies with TEF will also have other problems, such as heart or other digestive tract disorders (Public Med Health 2011) PROGNOSIS Tracheoesophageal fistula and esophageal atresia are life-threatening problems and need treatment right away. If these problems are not treated, your child may breathe saliva and fluids from the stomach into the lungs. This is called aspiration. It can cause choking and pneumonia (lung infection). Your child cannot swallow and digest food safely, or at all so surgery is performed. This surgery is almost always done soon after birth. Surgery is done while the child is in a deep sleep and pain-free from general anesthesia. TEACHING You will be able to bring your baby home once he or she is taking feedings by mouth or gastrostomy tube, and is gaining weight (Med line Plus 2013). Surgical and perioperative management of congenital TEFs have improved significantly. Survival rates of 100%
Clinical IV
January 30, 2013
PATHOPHYSIOLOGY
In a 4- to 6-week-old embryo, the caudal part of the foregut forms a ventral diverticulum that evolves into the trachea. The longitudinal tracheoesophageal fold fuses to form a septum that divides the foregut into a ventral laryngotracheal tube and a dorsal esophagus. The posterior deviation of the tracheoesophageal septum causes incomplete separation of the esophagus from the laryngotracheal tube and results in a TEF. (Medscape 2013)
INCIDENCE
Esophageal atresia is a congenital defect, which means it occurs before birth. Other types of esophageal atresia involve narrowing of the esophagus, and may also be associated with other birth defects. Esophageal atresia occurs in about 1 out of 4,000 births. CAUSES There are several types. In most cases, the upper esophagus ends and does not connect with the lower esophagus and stomach. The top end of the lower esophagus connects to the windpipe. This connection is called a tracheoesophageal fistula (TEF). Some babies with TEF will also have other problems, such as heart or other digestive tract disorders (Public Med Health 2011) PROGNOSIS Tracheoesophageal fistula and esophageal atresia are life-threatening problems and need treatment right away. If these problems are not treated, your child may breathe saliva and fluids from the stomach into the lungs. This is called aspiration. It can cause choking and pneumonia (lung infection). Your child cannot swallow and digest food safely, or at all so surgery is performed. This surgery is almost always done soon after birth. Surgery is done while the child is in a deep sleep and pain-free from general anesthesia. TEACHING You will be able to bring your baby home once he or she is taking feedings by mouth or gastrostomy tube, and is gaining weight (Med line Plus 2013). Surgical and perioperative management of congenital TEFs have improved significantly. Survival rates of 100%
References: Retrieved From 1. http://emedicine.medscape.com/article/186735-overview#showall 2. http://www.nlm.nih.gov/medlineplus/ency/article/002934.htm 3. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001957/