Find information on thousands of medical conditions and prescription drugs.

Tracheoesophageal fistula

A tracheoesophageal fistula is a connection (fistula) between the esophagus and the trachea. It is commonly seen with esophageal atresia. Congenitally it occurs because the tracheoesphageal ridges fail to fuse. Additionally, fistulas are made artificially in patients who have undergone a laryngectomy, as this can serve as way for generating sound in replacement of the removed voice box.

Home
Diseases
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
Candidiasis
Tachycardia
Taeniasis
Talipes equinovarus
TAR syndrome
Tardive dyskinesia
Tarsal tunnel syndrome
Tay syndrome ichthyosis
Tay-Sachs disease
Telangiectasia
Telangiectasia,...
TEN
Teratoma
Teratophobia
Testotoxicosis
Tetanus
Tetraploidy
Thalassemia
Thalassemia major
Thalassemia minor
Thalassophobia
Thanatophobia
Thoracic outlet syndrome
Thrombocytopenia
Thrombocytosis
Thrombotic...
Thymoma
Thyroid cancer
Tick paralysis
Tick-borne encephalitis
Tietz syndrome
Tinnitus
Todd's paralysis
Topophobia
Torticollis
Touraine-Solente-Golé...
Tourette syndrome
Toxic shock syndrome
Toxocariasis
Toxoplasmosis
Tracheoesophageal fistula
Trachoma
Transient...
Transient Global Amnesia
Transposition of great...
Transverse myelitis
Traumatophobia
Treacher Collins syndrome
Tremor hereditary essential
Trichinellosis
Trichinosis
Trichomoniasis
Trichotillomania
Tricuspid atresia
Trigeminal neuralgia
Trigger thumb
Trimethylaminuria
Triplo X Syndrome
Triploidy
Trisomy
Tropical sprue
Tropophobia
Trypanophobia
Tuberculosis
Tuberous Sclerosis
Tularemia
Tungiasis
Turcot syndrome
Turner's syndrome
Typhoid
Typhus
Tyrosinemia
U
V
W
X
Y
Z
Medicines

Read more at Wikipedia.org


[List your site here Free!]


Tracheoesophageal fistula caused by ingestion of a caustic substance - Imaging Clinic
From Ear, Nose & Throat Journal, 5/1/03 by Santiago Restrepo

A 16-year-old girl was brought to the emergency room after she had attempted suicide by ingesting drain cleaner that contained the caustic substance sodium hydroxide. Despite appropriate medical treatment, 1 week later the patient developed a persistent cough, especially after swallowing. Helical computed tomography (CT) of the neck and chest with three-dimensional reconstruction detected an abnormal communication between the trachea and the esophagus that was consistent with a tracheoesophageal fistula.

A tracheoesophageal fistula is an uncommon clinical problem with several possible etiologies: congenital abnormality, malignancy (e.g., lung carcinoma, lymph node metastasis, or esophageal carcinoma), complication of radiotherapy, trauma to the respiratory tract or esophagus (e.g., from endoscopic instrumentation), blunt or penetrating trauma, surgical trauma, foreign-body perforation, contact with a corrosive substance, postemetic rupture, infection, and inflammation.

The common initial signs of a tracheoesophageal fistula are a sudden cough associated with ingestion of fluids or solids (Ono's sign), (1) the production of sputum mixed with food, recurrent pulmonary infections, weight loss, and profound weakness. (2) Although most of the acquired tracheoesophageal fistulas are secondary to malignancy or iatrogenic procedures, a fistula caused by a caustic substance is an important finding in any patient who has a history of toxicity with these substances, especially children.

The imaging method of choice for the evaluation of a tracheoesophageal fistula is an oral contrast study of the esophagus. Meglumine diatrizoate is used in upper gastrointestinal examinations when a perforation is suspected. The positive sign for tracheoesophageal fistula is the passage of the contrast media from the esophagus to the trachea, with or without delineation of the fistulous communication. (2) In oblique projections of the upper thorax, the pattern of contrast media in the esophagus, trachea, and fistulous tract can resemble the letter H, especially in patients with congenital fistulas. (3)

CT has proven to be valuable in the evaluation of the trachea and esophagus when a trachecesophageal fistula is suspected. Thin-section helical CT images are used to evaluate the tracheal and esophageal walls. If there is an anomalous communication between these two structures, the wall defect can be identified. Three-dimensional reconstructions and virtual endoscopy can also be helpful in identifying these lesions. In cases of a large communication, a unique lumen develops from the previously normal airway and upper gastrointestinal tract (figure).

References

(1.) Gerzic Z, Rakic S, Randjelovic T. Acquired benign esophagorespiratory fistula: Report of 16 consecutive cases. Ann Thorac Surg 1990;50:724-7.

(2.) Gudovsky LM. Koroleva NS, Biryukov Y, et al. Tracheoesophageal fistulas. Ann Thorac Surg 1993;55:868-75.

(3.) Grainger RG, Allison DJ, Adam A, Dixon AK, eds. Grainger and Allison's Diagnostic Radiology. A Textbook of Medical Imaging. 4th ed. London: Churchill Livingstone, 2001:647-8.

From the Department of Radiology, Louisiana State University Health Sciences Center, New Orleans.

COPYRIGHT 2003 Medquest Communications, LLC
COPYRIGHT 2003 Gale Group

Return to Tracheoesophageal fistula
Home Contact Resources Exchange Links ebay