Treatment

A baby with oesophageal atresia or tracheo-oesophageal fistula should be nursed with a tube providing continuous suction drainage of the oesophageal pouch.

Medical management involves rehydration and correction of any electrolyte imbalance or hypoglycaemia. If there is an aspiration pneumonia then this should be treated with antibiotics.

Surgical correction of the abnormality is made by an end-to-end anastomosis through a right thoracotomy in the bed of the fifth rib. The azygous vein is doubly ligated, divided, and the mediastinal pleura incised. If a fistula is present, it is divided at its entrance into the trachea and sewn shut. The proximal pouch is then mobilized and the end-to-end anastomosis is established.

With early diagnosis and surgical intervention, as few as 10% of patients perish.

Reference

1. Reed MF, Mathisen DJ. Tracheoesophageal fistula. Chest Surg Clin N Am. 2003 May;13(2):271-89.