Q39.1: Atresia of oesophagus with tracheo-oesophageal fistula

There is a congenital defect which means the esophagus is not fully formed.

The oesophagus or gullet connects the mouth with the stomach. It is a muscular tube. The muscles in the oesophagus move food into the stomach. If tissue fails to develop properly, defects can occur. With this defect, there is a discontinuity in the esophagus. So the esophagus consists of 2 parts. The two sections were closed at their ends. If there is a discontinuity in the esophagus, food cannot get from the mouth to the stomach. Saliva is also unable to flow to the stomach, so it accumulates in the mouth.

With this defect, the esophagus is also connected to the airways by a passage at the side. The passage can connect the upper or lower part of the esophagus with the airways. This passage is often located between the lower part of the esophagus and the trachea. The trachea or windpipe begins below the larynx. It consists of many cartilage rings that strengthen the trachea. The trachea splits into 2 large airways in the middle of the chest. The airways then go into the lungs and branch out further.

A connecting passage between the esophagus and the airways can cause a variety of problems. If the passage is towards the bottom, fluid can get from the stomach into the airways. If the passage is towards the top, fluid can get into the airways via the mouth. From the airways, the fluid flows on into the lungs. If fluid gets into the airways or lungs, it can cause coughing. Breathing can also be impaired. The lungs can also become inflamed.