Tracheoesophageal fistula

　　Tracheoesophageal fistula is caused by congenital embryonic developmental abnormalities, forming a fistula between the trachea and esophagus. Commonly associated with esophageal atresia and incomplete tracheal development, with the fistula communicating with the esophagus. The esophagus may be blind-ended and atretic, dilated into a cystic shape, or there may be tracheoesophageal fistula without esophageal atresia. In a few cases, the bronchus communicates with the esophagus, forming a bronchoesophageal fistula.

　　The complications of tracheoesophageal fistula mainly include long-term recurrent lower respiratory tract infections, aspiration pneumonia, and respiratory distress syndrome. Among them, aspiration pneumonia is caused by aspiration of acidic substances such as animal fat, food, gastric contents, and other irritant liquids and volatile hydrocarbons, which can lead to chemical pneumonia. Severe cases may develop respiratory failure or respiratory distress syndrome.

　　Newborns with tracheoesophageal fistula and esophageal atresia may present with coughing during feeding and regurgitation, vomiting out pharyngeal secretions. They often die quickly due to aspiration pneumonia and respiratory distress. The clinical manifestations depend on the anatomical characteristics and severity of the malformation, most commonly presenting with coughing after eating, vomiting, long-term recurrent lower respiratory tract infections, and occasionally hemoptysis. The symptoms of coughing and regurgitation are more pronounced during feeding or crying. Patients with mild symptoms may not appear until adulthood.

　　Tracheoesophageal fistula is caused by congenital embryonic developmental abnormalities, forming a fistula between the trachea and esophagus. Therefore, there are no targeted preventive measures for this disease. It is recommended that pregnant women should have examinations and inspections before and during pregnancy to reduce the likelihood of the fetus being affected. At the same time, early detection, early diagnosis, and early treatment should be done, which is an important method for preventing this disease.

　　Tracheoesophageal fistula is caused by congenital embryonic developmental abnormalities, forming a fistula between the trachea and esophagus. This disease can be diagnosed by the following examination methods:

　　1. If the white blood cell count of the infected person is increased.

　　2. Chest X-ray shows only X-ray signs of aspiration pneumonia, manifested as small patchy inflammatory shadows along the bronchial distribution, which are common in the middle and lower lung fields. In cases of chronic recurrent infection, dense nodular or filamentous shadows may be seen.

　　3. Bronchography (iodine oil) and esophagography (iodine oil, barium) can help clarify the location and shape of the fistula.

　　4. Endoscopic examination, including fiberoptic bronchoscopy and esophagoscopy, is used to assist in diagnosis and local treatment.

　　The treatment of tracheoesophageal fistula is mainly surgical. After surgery, dietary adjustment should focus on liquid and semi-liquid foods. Avoid any irritant foods to prevent infection and injury at the anastomosis. Common foods should be consumed only after permission from the doctor. The diet should be high in nutrition and can include foods such as Job's tears porridge, glutinous rice porridge, fresh eggs, fresh meat, milk, and fresh fruits and vegetables based on daily taste habits. If there is a lack of appetite, fresh hawthorn, Chinese plum, pomegranate, and other foods can be used to adjust taste and increase appetite. Soup can also be made with orange peel, ginger, rock sugar, and chicken for consumption.

　　Patients with tracheoesophageal fistula should undergo early surgical treatment. According to the condition, the fistula should be repaired, excised, and (or) the esophagus reconstructed, and a short-term gastrostomy should be performed to facilitate feeding and control aspiration pneumonia. The success rate of surgical treatment is high, and the prognosis is good, but postoperative follow-up observation should be paid attention to. Some patients may still experience recurrent respiratory tract infections due to reasons such as incomplete closure of the lower esophageal sphincter and retrograde peristalsis, and should adopt a head-up sleeping position and feeding. In recent years, the use of endoscopy for electrocoagulation or NdyAG laser repair of tracheoesophageal fistula has achieved good results and has few adverse reactions.