Chromosomal and Genetic Conditions

Tracheoesophageal Fistula and Esophageal Atresia Symptoms and Diagnosis

Symptoms of TEF and EA

Babies who have TEF but not EA usually don’t have symptoms at birth, and it can take doctors several weeks to diagnose the condition. Babies with TEF usually only have mild coughing or respiratory symptoms. Those symptoms usually happen while the babies are feeding. Signs include:

  • Coughing often while feeding
  • Frequent lung infections

When babies have both TEF and EA, the symptoms are usually obvious right after birth. The most common signs of combined TEF/EA are:

  • Breathing problems
  • Coughing or choking when babies try to swallow

Babies with TEF/EA may have other problems that are linked to the conditions. Doctors call this the VACTERL association. Each letter stands for a possible problem:

  • V = vertebral, problems with the bones in the spine
  • A = imperforate anus, a problem with the way a baby’s anus or rectum has formed
  • C = cardiac, problems with the heart
  • TE = tracheoesophageal fistula and esophageal atresia
  • R = renal (kidney) problems
  • L = limb, problems with the bones in the arms

All babies with TEF/EA will need evaluations to see if they have any of these problems. These babies may need:

  • X-rays to check for spinal problems and problems with arms or legs
  • Ultrasound (echocardiogram, or echo) to check for heart problems
  • Kidney ultrasound and possibly other tests of their kidneys
  • Treatment for problems with how the anus is formed (imperforate anus)

If your baby has any of these problems, the doctor will explain which tests or treatment they need.

Tracheoesophageal Fistula and Esophageal Atresia Diagnosis

Sometimes doctors can diagnose TEF/EA before your baby is born based on the results of a prenatal ultrasound. Our Prenatal Diagnosis and Treatment Program can help your family and your obstetricians get ready for the birth and plan your baby’s care.

After your baby is born, doctors diagnose TEF/EA by trying to insert a nasogastric tube (NG tube). The tube is supposed to pass through the baby’s nose, down the esophagus and into the stomach.

In children who have EA, the NG tube hits a blocked end, usually in the mid-chest. Doctors can see this blockage on an X-ray. Usually they need no other diagnostic test.

In children who have both EA and TEF, the X-ray also can show gas in the baby’s stomach. Because the esophagus has not formed properly, the only way gas can get into the stomach is through a fistula (the abnormal channel between the esophagus and trachea). Children who have only EA do not show gas in the stomach.

To find TEF without EA, doctors sometimes use a barium swallow test. The doctor has your child swallow a chalky liquid called barium. The barium helps the digestive tract show up on X-rays.

After diagnosis, your doctor will talk to you about different TEF/EA treatment options.

Contact Us

To learn more about treatment for TEF/EA at Seattle Children’s, call our General and Thoracic Surgery Department at 206-987-2794 x4.