Tracheoesophageal Fistula in Children

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Contact the Esophageal Airway Treatment Center

  • 1-617-355-3038

Tracheoesophageal fistula (TEF) is an abnormal connection in one or more places between your child's esophagus and the trachea. TEF can cause respiratory (breathing) problems as a result of stomach (gastric) juices passing through the fistula and into the lungs. TEF usually occurs with esophageal atresia (EA).

At Boston Children’s Esophageal Airway Treatment Center, our doctors usually repair this condition in one operation in the first day or two of your baby's life. Many surgeons will try to repair the TEF with minimally invasive techniques, unsuccessfully, increasing the risk that it will reoccur. The scarring caused by these procedures makes further repair more difficult. Recurring (repeating) TEF can be larger and more dangerous. Recurring TEF can potentially damage other structures, such as the voice box.

What is Tracheoesophageal Fistula?

Normally, the esophagus (the tube that connects the throat to the stomach) and the trachea (the tube connecting the throat to the windpipe and lungs) are separate.

A tracheoesophageal fistula is an abnormal connection between these two tubes. As a result, swallowed liquids or food can be aspirated (inhaled) into your child’s lungs. Feeding into the stomach directly can also lead to reflux (regurgitation) and inhalation (aspiration) of the stomach acid and food. Your child can have one or more fistulas (TEFs).

After repair of a TEF, there is an increasing likelihood that the TEF will return (recurrent TEF), and be larger and more dangerous with time. It is also possible, though rare, that a TEF can be present from the upper end of the esophagus to the trachea. This means that swallowed liquids would pass directly into the lungs.

TEF often occurs with esophageal atresia.

Questions to Ask Your Doctor About Your Child’s Care

After your child is diagnosed with tracheoesophageal fistula, you may feel overwhelmed with information.  Your neonatologist or pediatric surgeon may suggest that your child be treated at the hospital where you delivered.

However, given the rarity of this condition and the importance of a successful first treatment to avoid further recurrence(repeated procedures can result in complications), it is important to know all of your options.  You want the best possible care for your child, which means working with surgeons who have significant experience treating this condition and have proven, excellent results.

Here are some questions you may want to ask your doctor:

  • Is my child’s tracheoesophageal fistula associated with another condition?
  • How will you manage my child’s symptoms?
  • What’s the best treatment for my child right now?
  • What are the possible short and long-term complications of treatment?
  • How many cases of TEF (both new and recurrent) have been treated at your hospital in the last year?
  • Do any of your surgeons have experience with the Foker process or the jejunum interposition technique?
  • Do your surgeons know how to remove the tracheal diverticulum?
  • Do your surgeons know how to repair the trachea?
  • Do your doctors know how to correct tracheomalacia?
  • Do your surgeons know how to do a rotation esophagoplasty?
  • Do your surgeons treat an associated esophageal stricture?
  • What is the long-term outlook for my child?
  • What services are available to help my child and my family to cope?
  • May I speak with some parents of children who have been treated for this condition here?

Make an Appointment

To make an appointment or speak with a member of our team, please call 617-355-3038.

International Patients

For families residing outside of the United States, please call Boston Children's International Health Services at +01-617-355-5209.

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- Sandra L. Fenwick, President and CEO

Boston Children's Hospital
300 Longwood Avenue, Boston, MA 02115
For Patients: 617-355-6000
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