TE Fistulas / VACTERL Syndrome

Introduction

• Embryological malformation in a newborn with
  • distal esophagus arising from trachea
  • proximal esophagus ending in a blind pouch
• Can be part of a broader constellation of findings called VACTERL association
• associations are seemingly unrelated malformations that occur together 

Presentation

• Symptoms
  • difficulty feeding
    • inability to swallow
  • pneumonia
    • aspiration of stomach contents into lungs
  • maternal polyhydramnios
    • fetus cannot swallow amniotic fluid for reentry of fluid into vasculature
• Physical exam
  • associated VACTERL syndrome findings 
    • Vertebral abnormalities
    • Anal atresia
    • Cardiac defects
    • TE fistula
    • Renal disease
• Limb abnormalities

Treatment

• Surgical correction