Tracheoesophageal Fistula Clinical Presentation

Updated: Nov 07, 2018
  • Author: Sat Sharma, MD, FRCPC; Chief Editor: Vinay K Kapoor, MBBS, MS, FRCSEd, FICS, FAMS  more...
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History & Physical Examination


Esophageal atresia in the fetus should be considered as a cause of maternal polyhydramnios. Absence of stomach gas on prenatal ultrasonography is another indication of esophageal atresia.

Neonates with esophageal atresia usually develop copious, fine white frothy bubbles of mucus in the mouth and nose. Secretions recur despite suctioning.

Infants may develop rattling respiration and episodes of coughing and choking in association with cyanosis.

Symptoms worsen during feeding in the presence of a tracheoesophageal fistula (TEF).

The symptoms induced by malignant TEFs are cough, aspiration (especially on swallowing liquids), and fever. The average duration of symptoms from onset to diagnosis is approximately 12 days.

Physical examination

Perform a careful physical examination to document/exclude other associated developmental anomalies.

In the presence of a TEF, abdominal distention may occur secondary to collection of air in the stomach.