What is Esophageal Atresia (EA)?

Congenital Esophageal Atresia (EA) or Tracheoesophageal Fistula (TEF, or TOF in the United Kingdom) is a fairly common congenital anomaly (or birth defect) that usually involves the esophagus (or feeding tube), and the trachea (or windpipe). Between 1 in 2,400 and 1 in 4,500 babies are born with EA.

Esophageal Atresia means that the middle portion of the esophagus (oesophagus in the United Kingdom) fails to form, so the top part of the esophagus (just below the mouth) doesn’t connect with the lowest part of the esophagus (which joins the stomach). As a result, infants with Esophageal Atresia are unable to pass food from the mouth, into the stomach.

Tracheoesophageal Fistula means that the infant is born with a connection between the trachea and the esophagus. As a result, depending on the location of the TEF, food can pass from the esophagus into the trachea and then into the lungs, or, stomach contents and acid can pass into the trachea, and then into the lungs. This leads to choking and can lead to pneumonia. Movement of food or stomach contents into the airway is called aspiration, and pneumonia resulting from aspiration is called aspiration pneumonia.

About 90% of people with TEF also have esophageal atresia, and some centers (and web sites) use the terms pretty much interchangeably. On this web site, EA will generally refer to both conditions, in accordance with the International Network on Esophageal Atresia.

This web site is designed for people with EA and their families, and non-expert health professionals. It will tell you about the effects of EA, and the management of EA and its complications. TEF can occur in adults from cancers eroding through the wall of the trachea or esophagus, creating a connection between the two structures. This is called a Secondary TEF, and this condition will not be discussed in this web site.

 Tom Kovesi MD, Pediatric Respirologist, Children’s Hospital of Eastern Ontario, Ottawa, Ontario Canada