Congenital tracheoesophageal, umbilical, vascular and meningeal fistulas

Abstract

Tracheoesophageal fistula and esophageal atresia are rare congenital abnormalities which represent two components of VACTERL association of anomalies. They are frequently associated with laryngeal cleft. Congenital umbilical fistulas result from failure of obliteration of the fetal vitellointestinal duct or urachus. Vitellointestinal duct abnormalities are rare and they include Meckel's diverticulum, vitelline cyst and vitellointestinal fistula. Urachal anomalies are very rare, and they include diverticula, cysts, sinuses and fistulas. Ultrasonography and fistulography are helpful investigations for the diagnosis of urachal fistulas; the fistula is surgically excised together with the adjoining apex of the urinary bladder. Congenital prepubic sinuses and urethroperineal fistulas are other rare anomalies. Congenital coronary artery fistulas may be also discovered between the coronary arteries and the four cardiac chambers or the great vessels of the heart. Coronary arteriovenous fistulas and absent ductus venosus with abnormal venous circulation could occur as rare congenital anomalies. Other rare congenital arteriovenous fistulas could exist in the thorax, abdomen, pelvis, and cranial and spinal meninges.