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Tracheoesophageal Fistula

WHAT YOU NEED TO KNOW:

A tracheoesophageal fistula (TEF) is an abnormal connection between your trachea and esophagus. Air travels through the trachea into the lungs. The esophagus carries food from the mouth to the stomach. With TEF, food can pass from the esophagus into your lungs. This can cause breathing problems or infections, such as pneumonia.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Raise the head of your bed to help you breathe easier.

You can also raise your head and shoulders using pillows. Call a healthcare provider immediately if you feel short of breath.

An IV

is a small tube placed in your vein that is used to give you medicine or liquids.

A nasogastric (NG) tube

may be put into your nose and passed down your throat until it reaches your stomach. Food and medicine may be given through an NG tube if you cannot take anything by mouth.

Medicines:

  • Antibiotics help treat or prevent an infection caused by bacteria.
  • Pain medicine may be given to decrease pain. Do not wait until the pain is severe before you ask for more medicine.
  • Antipyretics help decrease a fever.

Tests:

  • Blood tests can show the amount of oxygen in your blood.
  • A barium x-ray of your throat and esophagus may show the fistula. You will drink a thick, milky liquid called barium. Barium helps your fistula show up clearly on the x-ray.
  • A chest x-ray may show signs of infection, such as pneumonia. A chest x-ray may also show other problems caused by your fistula.
  • A bronchoscopy is a procedure to look for a fistula inside your airway. A thin tube with a light and camera is inserted into your mouth and moved down your throat to your airway. You will be given medicine to numb your throat and help you relax during the procedure.
  • A CT scan , may show the fistula. You may be given a dye before the scan. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye.
  • An endoscopy is a procedure to look for a fistula inside your esophagus. A thin tube with a light and camera is inserted into your mouth and moved down your esophagus. You will be given medicine to numb your throat and help you relax during the procedure.

Treatment:

  • A dietitian may talk to you about feeding and nutrition. A speech therapist may also teach you safe ways to swallow if you have trouble swallowing. You may not be able to eat food for a period of time. You may need parenteral nutrition through your IV.
  • Extra oxygen may be needed if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your healthcare provider before you take off the mask or oxygen tubing.
  • A ventilator is a machine that gives you oxygen and breathes for you when you cannot breathe well on your own. An endotracheal (ET) tube is put into your mouth or nose and attached to the ventilator. You may need a trach if an ET tube cannot be placed. A trach is a tube put through an incision and into your windpipe.
  • A stent (tube) may be placed in your esophagus or trachea to keep it open.
  • Surgery may be needed to close or fix the fistula. The esophagus may be reconnected to make it a continuous tube that is separate from the trachea. In some cases, a piece of tissue from the large bowel is used to join the parts. Ask your healthcare provider for more information about surgery.

RISKS:

Your fistula may open after treatment. Your symptoms may return. You may develop scarring from surgery, which can block your trachea or esophagus. Without treatment, you may have trouble eating and drinking. You may have trouble breathing or develop a lung infection. Your heart and brain may not get enough oxygen. This can be life-threatening.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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