Tracheoesophageal Fistula Differential Diagnoses

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

Consider adult presentation of congenital tracheoesophageal fistula (TEF) (ie, recurrent TEF) in adults who present with cough and recurrent aspiration pneumonia. [11] Recurrent TEF in adults may be a late complication of surgical repair performed when they were children.

Pharyngeal pseudodiverticulum should be considered in the differential diagnosis of TEFs. This may occur secondary to traumatic perforation of the posterior pharynx from finger insertion into the oropharynx during labor or following vigorous efforts at tube insertion during resuscitation of the newborn. These patients develop pneumomediastinum.

A very rare cause of neonatal respiratory distress is tracheal agenesis, which is always fatal within hours of birth. In tracheal agenesis, a nasogastric tube can be inserted easily.

Zenker diverticulum is also known as posterior hypopharyngeal pouch and pharyngoesophageal diverticulum. This condition involves herniation of mucosa and submucosa through the oblique and transverse fibers of the cricopharyngeus muscle. The blind pouch develops at the pharyngoesophageal junction at the level of the C5-C6 disc space. The pouch is the result of hyperdynamic cricopharyngeal sphincter contraction associated with an abnormality of cricopharyngeal relaxation.

Differential Diagnoses