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Esophageal Atresia/Tracheoesophageal Fistula: Multimedia

Author: Keith A Kronemer, MD, Assistant Professor, The Mallinckrodt Institute of Radiology, Washington University School of Medicine; Consulting Staff, St Louis Children's Hospital
Coauthor(s): Alison Snyder-Warwick, MD, Research Fellow, Department of Developmental Biology and Department of Surgery, Division of Plastic and Reconstructive Surgery, Washington University School of Medicine
Contributor Information and Disclosures

Updated: Jun 23, 2009

Multimedia

Esophageal atresia (EA) with distal tracheoesopha...
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Media file 1: Esophageal atresia (EA) with distal tracheoesophageal fistula (TEF). Frontal view of the chest and abdomen of a neonate demonstrates a tube in the proximal pouch in this patient with EA. The presence of bowel gas implies the presence of a distal TEF, making this the most common type of EA/TEF.
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Esophageal atresia (EA) with distal tracheoesopha...

Esophageal atresia (EA) with distal tracheoesophageal fistula (TEF). Frontal view of the chest and abdomen of a neonate demonstrates a tube in the proximal pouch in this patient with EA. The presence of bowel gas implies the presence of a distal TEF, making this the most common type of EA/TEF.

Isolated esophageal atresia (EA). Frontal view of...
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Media file 2: Isolated esophageal atresia (EA). Frontal view of the chest and abdomen demonstrates a catheter in the proximal pouch in this patient with EA. Note the absence of bowel gas in this patient with EA, but it is not associated with a tracheoesophageal fistula (TEF).
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Isolated esophageal atresia (EA). Frontal view of...

Isolated esophageal atresia (EA). Frontal view of the chest and abdomen demonstrates a catheter in the proximal pouch in this patient with EA. Note the absence of bowel gas in this patient with EA, but it is not associated with a tracheoesophageal fistula (TEF).

H-type tracheoesophageal fistula (TEF). Oblique b...
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Media file 3: H-type tracheoesophageal fistula (TEF). Oblique barium esophagogram demonstrates a fistula (arrow) arising from the anterior esophagus and extending anterosuperiorly to the trachea.
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H-type tracheoesophageal fistula (TEF). Oblique b...

H-type tracheoesophageal fistula (TEF). Oblique barium esophagogram demonstrates a fistula (arrow) arising from the anterior esophagus and extending anterosuperiorly to the trachea.

Vertebral, anorectal, cardiac, tracheal, esophage...
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Media file 4: Vertebral, anorectal, cardiac, tracheal, esophageal, renal, and limb (VACTERL) association. Frontal radiograph in a patient with esophageal atresia (EA) without a tracheoesophageal fistula (TEF). Note the catheter in the proximal pouch and the butterfly vertebra (asterisks) at the level of T8 in this patient with associated VACTERL.
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Vertebral, anorectal, cardiac, tracheal, esophage...

Vertebral, anorectal, cardiac, tracheal, esophageal, renal, and limb (VACTERL) association. Frontal radiograph in a patient with esophageal atresia (EA) without a tracheoesophageal fistula (TEF). Note the catheter in the proximal pouch and the butterfly vertebra (asterisks) at the level of T8 in this patient with associated VACTERL.

False-positive finding of esophageal atresia (EA)...
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Media file 5: False-positive finding of esophageal atresia (EA). Image demonstrates a feeding tube coiled in the proximal esophagus (E). An umbilical arterial catheter (U) is noted at the level of T11. The catheter was repositioned and extended to the stomach, with no alteration of the infant's cry (see Image 6.)
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False-positive finding of esophageal atresia (EA)...

False-positive finding of esophageal atresia (EA). Image demonstrates a feeding tube coiled in the proximal esophagus (E). An umbilical arterial catheter (U) is noted at the level of T11. The catheter was repositioned and extended to the stomach, with no alteration of the infant's cry (see Image 6.)

False-positive finding of esophageal atresia. Fol...
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Media file 6: False-positive finding of esophageal atresia. Follow-up image in the patient in Image 5 demonstrates the tube (T) extending to the stomach. The endotracheal tube (ET) and umbilical arterial catheter (U) are also identified.
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False-positive finding of esophageal atresia. Fol...

False-positive finding of esophageal atresia. Follow-up image in the patient in Image 5 demonstrates the tube (T) extending to the stomach. The endotracheal tube (ET) and umbilical arterial catheter (U) are also identified.

Gapogram shows the location of the proximal pouch...
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Media file 7: Gapogram shows the location of the proximal pouch (P), which is suggested by the position of the catheter. The distal pouch location (D) is visualized with the reflux of contrast material through a previously placed gastrostomy tube (G). The distance between the proximal and distal pouches is measured on the adjacent radiopaque ruler.
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Gapogram shows the location of the proximal pouch...

Gapogram shows the location of the proximal pouch (P), which is suggested by the position of the catheter. The distal pouch location (D) is visualized with the reflux of contrast material through a previously placed gastrostomy tube (G). The distance between the proximal and distal pouches is measured on the adjacent radiopaque ruler.

Barium esophagogram obtained in a patient 3 weeks...
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Media file 8: Barium esophagogram obtained in a patient 3 weeks after esophageal repair shows the relative narrowing at the anastomotic site (A). Reflux (arrow) is seen with an associated sliding hiatal hernia (R).
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Barium esophagogram obtained in a patient 3 weeks...

Barium esophagogram obtained in a patient 3 weeks after esophageal repair shows the relative narrowing at the anastomotic site (A). Reflux (arrow) is seen with an associated sliding hiatal hernia (R).

Stricture with food bolus. Frontal view from a b...
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Media file 9: Stricture with food bolus. Frontal view from a barium swallow examination in a patient with a repaired EA shows a stricture at the anastomotic site, with a bolus of food proximal to the stricture.
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Stricture with food bolus. Frontal view from a b...

Stricture with food bolus. Frontal view from a barium swallow examination in a patient with a repaired EA shows a stricture at the anastomotic site, with a bolus of food proximal to the stricture.

More on Esophageal Atresia/Tracheoesophageal Fistula

Overview: Esophageal Atresia/Tracheoesophageal Fistula
Imaging: Esophageal Atresia/Tracheoesophageal Fistula
Follow-up: Esophageal Atresia/Tracheoesophageal Fistula
Multimedia: Esophageal Atresia/Tracheoesophageal Fistula
References
Further Reading
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Further Reading

Related eMedicine topics

 Gastroesophageal Reflux Disease

Tracheoesophageal Fistula (Gastroenterology)

Esophageal Atresia With or Without Tracheoesophageal Fistula

Gastroesophageal Reflux, Surgical Treatment

Clinical guidelines

World Gastroenterology Organisation practice guideline: esophageal varices. World Gastroenterology Organisation - Medical Specialty Society.  2008 Jun.  17 pages.  NGC:006695

Gastroesophageal reflux disease (GERD). University of Michigan Health System - Academic Institution.  2002 Mar (revised 2007 Jan).  10 pages.  NGC:005568

American Gastroenterological Association medical position statement on the management of gastroesophageal reflux disease. American Gastroenterological Association Institute - Medical Specialty Society.  2008 Oct.  14 pages.  NGC:006759

Clinical trials

 Rectal and Oral Omeprazole Treatment of Reflux Disease in Infants.

Clinical and Genetic Studies of VACTERL Association

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Keywords

esophageal atresia, EA, tracheoesophageal fistula, TEF, H-type tracheoesophageal fistula, H-type TEF, gastroesophageal reflux, congenital malformations, esophagus, congenital anomalies of the esophagus, esophageal atresia with or without tracheoesophageal fistula

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Contributor Information and Disclosures

Author

Keith A Kronemer, MD, Assistant Professor, The Mallinckrodt Institute of Radiology, Washington University School of Medicine; Consulting Staff, St Louis Children's Hospital
Keith A Kronemer, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, Radiological Society of North America, and Society for Pediatric Radiology
Disclosure: Nothing to disclose.

Coauthor(s)

Alison Snyder-Warwick, MD, Research Fellow, Department of Developmental Biology and Department of Surgery, Division of Plastic and Reconstructive Surgery, Washington University School of Medicine
Alison Snyder-Warwick, MD is a member of the following medical societies: Alpha Omega Alpha, Phi Beta Kappa, and Sigma Xi
Disclosure: Nothing to disclose.

Medical Editor

Fredric A Hoffer, MD, FAAP, FSIR, Professor of Radiology, University of Washington; Section Chief of Interventional Radiology, Department of Radiology, Seattle Children's Hospital and Regional Medical Center
Fredric A Hoffer, MD, FAAP, FSIR is a member of the following medical societies: American Academy of Pediatrics, Children's Oncology Group, Radiological Society of North America, Society for Pediatric Radiology, and Society of Interventional Radiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

David A Stringer, BSc, MBBS, FRCR, FRCPC, Professor, National University of Singapore; Head, Diagnostic Imaging, KK Women's and Children's Hospital, Singapore
David A Stringer, BSc, MBBS, FRCR, FRCPC is a member of the following medical societies: British Columbia Medical Association, Canadian Association of Radiologists, European Society of Paediatric Radiology, Ontario Medical Association, Radiological Society of North America, Royal College of Physicians and Surgeons of Canada, Royal College of Radiologists, and Society for Pediatric Radiology
Disclosure: Sirius d'innovation None Board membership

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, Resolution Imaging Medical Corporation
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

John Karani, MBBS, FRCR, Clinical Director of Radiology and Consultant Radiologist, Department of Radiology, King's College Hospital, London
John Karani, MBBS, FRCR is a member of the following medical societies: British Institute of Radiology, British Society of Interventional Radiology, Cardiovascular and Interventional Radiological Society of Europe, European Society of Gastrointestinal and Abdominal Radiology, European Society of Radiology, Radiological Society of North America, and Royal College of Radiologists
Disclosure: Nothing to disclose.

 
 
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