What is VACTERL Association
Tracheo-oesphageal Fistula
Oesophageal Atresia
What is OA/TOF?
Tracheo-oesophageal fistula and/or oesophageal atresia (OA/TOF) is an abnormal connection between the trachea and the oesophagus, a discontinuity (gap) in the oesophagus.
The baby is unable to move food/fluids from their mouth to their stomach.
These malformations affect between 50% to 80% of babies born with VACTERL association. [1]
Different anatomical types of OA/TOF
These are classified by the presence and location of the fistula and by where the oesophagus ends.
Surgical repair
This will be needed to reconnect the oesophagus, to prevent recurrent infections and support normal feeding and growth.
Possible signs and Symptoms and why they happen
Difficulty swallowing or the feeling that food gets stuck.
This can happen if the food pipe becomes narrow where surgery was done, or if the muscles of the food pipe do not move food down smoothly. Some people may also bring food back up after eating. [2]
Breathing or throat symptoms (such as shortness of breath or coughing).
Stomach acid can sometimes travel back up into the food pipe and airway, causing irritation. Ongoing lung problems or a rare return of the abnormal connection between the airway and food pipe can also cause these symptoms.
Chest and/or neck pain
This may be caused by spasms of the food pipe muscles, which can feel like sharp or squeezing pain and make swallowing uncomfortable.
Worsening heartburn or reflux
Ongoing reflux can irritate the lining of the food pipe. Over time, this may cause inflammation, narrowing, or changes to the lining of the oesophagus in some adults.
Dizziness, sweating, or diarrhoea after eating.
These symptoms may be caused by “dumping syndrome,” where food moves too quickly through the digestive system and affects blood sugar levels.
Low iron levels (anaemia).
Some medicines used to treat reflux can reduce the absorption of certain vitamins, which may lead to low iron levels over time.
N.B. descriptions of the Terms used here can be found in the Glossary section.
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