What is TEF Type H?

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H-type tracheoesophageal fistula (H-TEF) is a rare, life-threatening congenital anomaly, which accounts for 4- 5% of all esophageal atresias/ tracheoesophageal fistula (EA/TEF).

What is an H-type fistula?

H‐type fistula is a rare, isolated form of tracheo‐oesophageal fistula (TEF). A 9‐month‐old girl presented with paroxysms of persistent cough related to feeds. Repeated hospitalisations, empirical antibiotics, antitubercular treatment and various investigations failed to resolve her symptoms.

What is the diagnosis of esophageal atresia?

An esophageal atresia diagnosis is usually confirmed with an X-ray, which shows any abnormal development of the esophagus. In rare cases, esophageal atresia is diagnosed before birth during a prenatal ultrasound. This imaging test uses sound waves to create an image of the baby on a monitor.

What are some common clinical manifestations of tracheoesophageal fistula TEF )?

Symptoms of TE fistula or esophageal atresia:

Frothy, white bubbles in the mouth.
Coughing or choking when feeding.
Vomiting.
Blue color of the skin (cyanosis), especially when the baby is feeding.
Difficulty breathing.
Very round, full abdomen.

How is H type TE fistula diagnosed?

The clinical diagnosis of an H-type TEF has been associated with the triad of paroxysms of coughing or cyanosis with feeding, gaseous distension of the gastrointestinal tract and recurrent pneumonia or bronchitis. Performance of an esophagogram and bronchoscopy are eventually diagnostic.

How is H type fistula diagnosed?

What is the most common type of TEF?

The upper segment of the esophagus ends in a blind pouch and the lower segment is connected to the trachea via a TEF. This is the most common type of EA/TEF occurring in approximately 85 percent of individuals. A TEF is present connecting both the upper and lower segments of the esophagus to the trachea.

Can TEF be diagnosed in utero?

Prenatal Diagnosis of TEF/EA: Sometimes a TEF/EA will be diagnosed or strongly suspected before birth through routine ultrasound. The inability to see a stomach and maternal polyhydramnios during an ultrasound are suspicious findings that may indicate TEF/EA.

What causes TEF?

Causes of acquired TEFs include iatrogenic injury, blunt chest or neck trauma, prolonged mechanical ventilation via endotracheal or tracheostomy tube, and excessive tube cuff pressure in patients ventilated for lung disease. There has even been a case report of an impacted denture causing TEF.

How is tracheoesophageal fistula treated?

Make a small incision in your child’s neck or back, depending on the location of the TEF.
Divide the fistula, closing the connection between the esophagus and the trachea.
Remove the pouch from the back of the trachea where the TEF originated.

How is tracheoesophageal fistula diagnosed?

How is tracheoesophageal fistula diagnosed?

imaging studies, such as x-rays.
endoscopy or bronchoscopy, which are techniques for looking at the inside of your child’s airways using a thin tube fitted with a small light and camera.

How is H-type fistula (TEF) diagnosed?

Many diagnostic methods have been advocated for the diagnosis of H-type fistula. It is occasionally possible to diagnose an H type TEF clinically by passing a wide-bore nasogastric tube and placing the end into a jar of water or attaching it to a stethoscope.

How is H-type tracheostomy (TEF) diagnosed?

It is occasionally possible to diagnose an H type TEF clinically by passing a wide-bore nasogastric tube and placing the end into a jar of water or attaching it to a stethoscope. As the tube passes the fistula, air will be seen, or heard, to escape.

How common is congenital H-type tracheoesophageal fistula?

Background: Congenital H-type tracheoesophageal fistula (TEF) is very rare and represents <5 % of all congenital tracheoesophageal malformations. This is a national, multicenter review of our experience with isolated H-type TEF outlining clinical presentation, methods of diagnosis, associated anomalies, treatment and outcome

How is hepatocellular effusion (TEF) diagnosed?

Methods: Esophagography and/or cineesophagography, or bronchoscopy and simultaneous methylene blue administration confirmed the diagnosis of H-type TEF.