Esophageal and Airway Treatment Center | Diagnosis

The first step in treating your child’s esophageal or tracheal condition is getting an accurate and complete diagnosis. Our team must first understand all the problems facing your child before designing a treatment plan specifically for your child.

Esophageal atresia can be detected either pre-natally or very shortly after birth, usually right after your baby first tries to feed. If your baby has EA, she might sputter, cough and choke, because the liquid may be filling up the back of her throat and blocking her airway. There are a few ways to detect EA:

  • Ultrasound: Sometimes, long-gap esophageal atresia may show up on a prenatal ultrasound. A fetus may appear to have a very small or barely visible stomach on the ultrasound. But this doesn’t necessarily mean that the baby has esophageal atresia.  If your baby has been diagnosed with EA or EA is suspected, an appointment at our Maternal Fetal Care Center can confirm the diagnosis. You can also learn more about available patient resources, such as support groups.
  • Nasogastric tube: Once your child is born, our doctors can diagnose EA by inserting a small thin tube called a nasogastric tube through the nose. In a normal esophagus, the tube will pass through the nose, down the esophagus and into the stomach. In children who have EA, the tube hits a blocked end, usually in the mid-chest.
  • X-ray: Doctors can see a blockage in the esophagus on an X-ray, which can help your doctors determine if your child also has an abnormal connection (channel) in one or more places between the esophagus and the trachea. This connection is known as a tracheoesophageal fistula (TEF).

Families from around the world come to the Esophageal and Airway Treatment (EAT) Center at Boston Children’s Hospital for expert testing by a team of doctors with significant expertise in these disorders. Our doctors are focused on giving every child as normal an esophagus as possible, and a healthy life, no matter how severe or complicated the condition.

It is very important to have your child evaluated by doctors who diagnose and treat these disorders frequently. This expertise is necessary because:

  • Esophageal conditions can easily go undetected or are misdiagnosed and confused with other respiratory conditions, such as asthma.
  • The tests must be conducted with extraordinary care so that the esophagus is not damaged.
  • Many doctors are unfamiliar with the advanced procedures available to treat these conditions.

Advanced Testing for Esophageal Conditions at Boston Children’s Hospital

Our team of doctors will perform advanced and minimally invasive tests to understand your child’s condition as well other related problems that may exist, such as gastroesophageal reflux disease (GERD). These tests may include:

  • Imaging studies, such as X-rays, to look at your child’s esophagus and stomach, chest and abdomen
  • Dynamic bronchoscopy: During this procedure, your child’s doctor will use a thin instrument called a bronchoscope to look in your child’s airway to see whether his trachea is collapsing when he breathes out (or in).
  • Dynamic airway CAT (CT) scan: A non-invasive procedure that uses X-ray equipment and powerful computers to create detailed, cross-sectional images of your child's body
  • Airway fluoroscopy: A type of X-ray that allows the doctor to have a more detailed look at your child’s trachea
  • Nasogastric tube: A tube is inserted through a child’s nose to see if it can pass into the stomach (normal esophagus) or if it touches a blocked end (esophageal atresia).
  • Esophageal Motility Testing: Some children with esophageal conditions may also have trouble swallowing. The EAT Program works closely with Boston Children’s Aerodigestive Program to provide testing and treatment of these conditions. Specific tests may include esophageal manometry, during which a thin tube is placed through the nose or mouth into the esophagus to measure the pressure within the esophagus and the lower esophageal muscle (sphincter).
  • Swallowing studies
  • Laryngoscopy: Approximately 30 percent of EA/TEF patients have a difficult-to-diagnose condition called laryngeal cleft, which can cause difficulty breathing and aspiration of liquids with swallowing.

After the evaluation is complete, our experts will meet to review and discuss what they have learned about your child's condition. They will share the results with you and outline the best treatment options available.

Learn more about the treatments we offer.

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.