Tracheoesophageal fistula



Tracheoesophageal fistula

Gastrointestinal system

Gastrointestinal system


Tracheoesophageal fistula


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USMLE® Step 1 questions

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Tracheoesophageal fistula

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USMLE® Step 1 style questions USMLE

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A 3-hour-old male neonate is observed to have profuse drooling and coughing in the nursery. The patient was born at 39-weeks gestational age to a 27-year-old, gravida 2 para 2, mother via vaginal delivery. The pregnancy was complicated by polyhydramnios. Cardiac exam reveals a harsh holosystolic murmur most prominent at the left lower sternal border. The nurse attempts to pass a nasogastric tube into the patient’s stomach but encounters resistance after advancing 12 cm. Which of the following physical exam findings will most likely also be present in this patient? 

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Tracheoesophageal fistula/anomalies p. 368


Tracheoesophageal fistula (TEF) is a medical condition where there is an abnormal connection, or fistula, between the trachea (windpipe) and the esophagus (food pipe). In newborns, TEF occurs as a congenital birth defect caused by the failure of the trachea and esophagus to separate during fetal development. Symptoms of TEF include difficulty feeding, choking, coughing, and respiratory distress. In some cases, an infant may also develop aspiration pneumonia due to food or liquid entering the lungs through the fistula. Once diagnosed, prompt surgery is required to allow the food intake.


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