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Tracheoesophageal Fistula Newborn Presentation and Outcome: Case Series

Received: 17 June 2020     Accepted: 2 July 2020     Published: 13 July 2020
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Abstract

Tracheoesophageal fistula (TEF/TOF) represents one of the most rare congenital anomaly in pediatric centers. Its an abnormal connection (fistula) between esophagus and trachea, characterized by copious salivation associated with choking, coughing, vomiting, cyanosis coincident with the onset of feeding and aspiration. Tracheoesophageal fistula commonly associated with other congenital anomaly, particularly cardiac defects. Diagnose can be established early during antenatal care by ultrasonography and postnatal by babygram and esophagography. Definitive management of TEF is surgical procedure. In this study we want to present outcome of our patients with tracheoesophageal fistula. Three cases were identified as tracheoesophageal fistula type C. The first and second case suffered vomit after feeding, then underwent esophagography examination and got surgical procedure. The third case showed difficult entry of feeding tube and hypersalivation but did not get other supporting examinations due to worsening condition. The first case with stable condition and discharge from hospital, meanwhile the second and third case passed away due to severe comorbid. Tracheoesophageal fistula diagnosis should be done immediately for planning surgery procedure. Supportive management would be needed if there are comorbid diseases. The prognosis of TEF is determined by clinical improvement after surgery and comorbid disease.

Published in American Journal of Pediatrics (Volume 6, Issue 3)
DOI 10.11648/j.ajp.20200603.24
Page(s) 259-267
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Tracheoesophageal Fistula, Neonate, Presentation, Outcome

References
[1] Depaepe A., Dolk H., Lechat M. F. The epidemiology of tracheooesophageal fistula and Oesophageal atresia in Europe: EUROCAT working group. Arch Dis Child. 1993; 68: 743-48.
[2] Al-Rawi O., Booker P. D. Oesophageal atressia and trachea-oesophageal fistula. Contin Educ Anaesth Crit Care Pain 2007; 7 (1): 15-9.
[3] Harmon C. M., Coran A. G. Congenital anomalies of esophagus. In: Coran A. G, Adzick N. S, Krummel T. M., et al, editors. Pediatric Surgery. 7th eds. Elsevier Saunders. 2012: 893-918.
[4] Pedersen R. N., Calzolari E., Husby S., et al. Oesophageal atresia: prevalence, prenatal diagnosis and associated anomalies in 23 European regions. Arch Dis Child. 2012; 97: 227-32.
[5] Pretorius D. H., Drose J. A., Dennis M. A., Manchester D. K., Manco J. M. Tracheoesophageal fistula in utero. Twenty-two cases. J Ultrasound Med. 1987; 6: 509.
[6] Vijayaraghavan B. S. Antenatal diagnosis of esophageal atresia with tracheoesophageal fistula. J Ultrasound Med. 1996; 15: 417-9.
[7] Spitz L. Esophageal atresia. Lessons I have learned in a 40-year experience. J Pediatr Surg. 2006; 41 (10): 1635-40.
[8] Houben C. H., Curry J. I. Current status of prenatal diagnosis, operative management and outcome of esophageal atresia/tracheo-esophageal fistula. Prenat Diagn. 2008; 28 (7): 667-75.
[9] Nagata K., Kamio Y., Ichikawa T., Kadokura M., Kitami A., Endo S., Inoue H., Kudo S. E. Congenital tracheoesophageal fistula successfully diagnosed by CT esophagography. World J. Gastroenterol. 2006; 12 (9): 1476-8.
[10] Fitoz S., Atasoy C., Yagmurlu A. three-dimensional CT of congenital esophageal atresia and distal tracheoesophageal fistula in neonates: preliminary results. AJR Am J Roentgenol. 2000; 175 (5): 1403–1407.
[11] Bradshaw C. J., Thakkar H., Knutzen L., Marsh R., Pacilli M., et al. Accuracy of prenatal detection of tracheoesophageal fistula and oesophageal atresia. Journal of Pediatric Surgery. 2016; 51 (8): 1268-72.
[12] Waterston Dj, Bonham-Carter Re, Aberdeen E. Congenital trachea-oesophageal fistula in association with oesophageal atresia. Lancet. 1963 Jul 13; 2 (7298): 55-7.
[13] Gross, R. E. The surgery of infancy and childhood. Philadelphia, WB Saunders; 1953.
[14] Garcia H., Gutierrez M. F. Multidiscplinary management of patients with Esophageal atresia. Bol Med Hosp Infant Mex. 2011; 68 (6): 432-9.
[15] Meier J. D., Sulman C. G., Almond P. S., et al. Endoscopic management of recurrent congenital tracheoesophageal fistula: a review of techniques and results. Int J Pediatr Otorhinolaryngol. 2007; 71: 691-7.
[16] Peetsold M. G., Heij H. A., Nagelkerke A. F., et al. Pulmonary function impairment after tracheo-esophgeal fistula: a minor role for gastro-esophageal reflux disease. Pediatr Pulmonol. 2011; 46: 348-55.
[17] Kovesi T., Rubin S. Long-term complications of congenital esophageal atresia and/or tracheoesophageal fistula. Chest. 2004; 126: 915-25.
[18] Lopez P. J., Keys C., Pierro A., Drake D. P., Kiely E. M., Curry J. I., Spitz L. Oesophageal atresia: improved outcome in high-risk groups. J Pediatr Surg. 2006; 41: 331-4.
[19] Shah R., Varjavandi V., Krishnan U. Predictive factors for complications in children with esophageal atresia and tracheoesophageal fistula. Diseases of the Esophagus. 2015; 28: 216-23.
[20] Faugli A., Emblem R., Bjornland K., Diseth T. H. Mental health in infants with esophageal atresia. Infant Ment. Health J. 2009; 30: 40-56.
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Cite This Article
  • APA Style

    Putu Tarita Susanti, I Made Kardana, Kadek Deddy Ariyanta. (2020). Tracheoesophageal Fistula Newborn Presentation and Outcome: Case Series. American Journal of Pediatrics, 6(3), 259-267. https://doi.org/10.11648/j.ajp.20200603.24

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    ACS Style

    Putu Tarita Susanti; I Made Kardana; Kadek Deddy Ariyanta. Tracheoesophageal Fistula Newborn Presentation and Outcome: Case Series. Am. J. Pediatr. 2020, 6(3), 259-267. doi: 10.11648/j.ajp.20200603.24

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    AMA Style

    Putu Tarita Susanti, I Made Kardana, Kadek Deddy Ariyanta. Tracheoesophageal Fistula Newborn Presentation and Outcome: Case Series. Am J Pediatr. 2020;6(3):259-267. doi: 10.11648/j.ajp.20200603.24

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  • @article{10.11648/j.ajp.20200603.24,
      author = {Putu Tarita Susanti and I Made Kardana and Kadek Deddy Ariyanta},
      title = {Tracheoesophageal Fistula Newborn Presentation and Outcome: Case Series},
      journal = {American Journal of Pediatrics},
      volume = {6},
      number = {3},
      pages = {259-267},
      doi = {10.11648/j.ajp.20200603.24},
      url = {https://doi.org/10.11648/j.ajp.20200603.24},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20200603.24},
      abstract = {Tracheoesophageal fistula (TEF/TOF) represents one of the most rare congenital anomaly in pediatric centers. Its an abnormal connection (fistula) between esophagus and trachea, characterized by copious salivation associated with choking, coughing, vomiting, cyanosis coincident with the onset of feeding and aspiration. Tracheoesophageal fistula commonly associated with other congenital anomaly, particularly cardiac defects. Diagnose can be established early during antenatal care by ultrasonography and postnatal by babygram and esophagography. Definitive management of TEF is surgical procedure. In this study we want to present outcome of our patients with tracheoesophageal fistula. Three cases were identified as tracheoesophageal fistula type C. The first and second case suffered vomit after feeding, then underwent esophagography examination and got surgical procedure. The third case showed difficult entry of feeding tube and hypersalivation but did not get other supporting examinations due to worsening condition. The first case with stable condition and discharge from hospital, meanwhile the second and third case passed away due to severe comorbid. Tracheoesophageal fistula diagnosis should be done immediately for planning surgery procedure. Supportive management would be needed if there are comorbid diseases. The prognosis of TEF is determined by clinical improvement after surgery and comorbid disease.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Tracheoesophageal Fistula Newborn Presentation and Outcome: Case Series
    AU  - Putu Tarita Susanti
    AU  - I Made Kardana
    AU  - Kadek Deddy Ariyanta
    Y1  - 2020/07/13
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ajp.20200603.24
    DO  - 10.11648/j.ajp.20200603.24
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 259
    EP  - 267
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20200603.24
    AB  - Tracheoesophageal fistula (TEF/TOF) represents one of the most rare congenital anomaly in pediatric centers. Its an abnormal connection (fistula) between esophagus and trachea, characterized by copious salivation associated with choking, coughing, vomiting, cyanosis coincident with the onset of feeding and aspiration. Tracheoesophageal fistula commonly associated with other congenital anomaly, particularly cardiac defects. Diagnose can be established early during antenatal care by ultrasonography and postnatal by babygram and esophagography. Definitive management of TEF is surgical procedure. In this study we want to present outcome of our patients with tracheoesophageal fistula. Three cases were identified as tracheoesophageal fistula type C. The first and second case suffered vomit after feeding, then underwent esophagography examination and got surgical procedure. The third case showed difficult entry of feeding tube and hypersalivation but did not get other supporting examinations due to worsening condition. The first case with stable condition and discharge from hospital, meanwhile the second and third case passed away due to severe comorbid. Tracheoesophageal fistula diagnosis should be done immediately for planning surgery procedure. Supportive management would be needed if there are comorbid diseases. The prognosis of TEF is determined by clinical improvement after surgery and comorbid disease.
    VL  - 6
    IS  - 3
    ER  - 

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Author Information
  • Department of Child Health, Sanglah Hospital, Faculty of Medicine, Udayana University, Denpasar, Indonesia

  • Department of Child Health, Sanglah Hospital, Faculty of Medicine, Udayana University, Denpasar, Indonesia

  • Department of Surgery, Sanglah Hospital, Faculty of Medicine, Udayana University, Denpasar, Indonesia

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