TRACHEO-OESOPHAGEAL FISTULA : DEFINITION ,CLINICAL FEATURES , MANAGEMENT , COMPLICATIONS

          In majority of the cases lower end oesophagus communicates with the trachea& the upper end blind .

Clinical features : 

1. continuous pouring of saliva from the mouth in the new born baby is a diagnostic feature .
2.New born baby regurgitates all feeds .
3. Aspiration , cough & cyanosis are other features .
4. It is commonly associated with  maternal hydramnios
.

Management : 

1. Right thoracotomy , ligation of TOF  & primary anastomosis of oesophageal ends .
2. Feeding gastrostomy & oesophagostomy in type 3 fistla .
3. In difficult cases of long atretic segment colonic or gastric transposition is required .

Complications :

1.Pneumonia .
2.Reflux .
3.Dysphagia .
4.Anastomotic leak .

TOF should be recognised & diagnosed within 24 hours of birth by introducing a Ryle's tube .