Mnemonic

Tracheo-oesophageal Fistula Types

A memory aid for the commonest form of tracheo-oesophageal fistula.

Expansion

Proximal oesophageal atresia with a distal fistula in about 85 per cent

Expansion

The trachea and oesophagus arise from a common foregut tube, separated by the tracheo-oesophageal septum. Incomplete separation gives a fistula.

  • Type C - proximal oesophageal atresia with a distal fistula from trachea to lower oesophagus. About 85 per cent of cases
  • Type A - pure atresia with no fistula
  • Type E (H-type) - an intact oesophagus with a fistula connecting it to the trachea; may present late with recurrent chest infections

Antenatally the blind upper pouch prevents swallowing of amniotic fluid, causing polyhydramnios. After birth, air passes through the distal fistula into the stomach, giving a gas-filled abdomen on radiography, absent in pure atresia.

Look for associated VACTERL anomalies: vertebral, anorectal, cardiac, tracheo-oesophageal, renal and limb.