Diagnosis and Management of Isolated Tracheoesophageal Fistula: A Case Report
DOI:
https://doi.org/10.64387/tjs.2025.272270Keywords:
Tracheoesophageal fistula, Esophageal malformation, H-typeAbstract
Isolated tracheoesophageal fistula (TEF) or H-type TEF is a rare congenital malformation of the esophagus in which a fistula between the lower trachea and the membranous part of the esophagus may lead to choking precipitated by feeding. Because of its rareness, diagnosis and surgical management of this anomaly can be challenging. A 2-month-old male infant presented with frequent cough and occasional choking during breastfeeding, beginning from his 3 days of life. At 2 weeks of age, the infant developed tachypnea and fever and was diagnosed with aspiration pneumonitis. His symptoms improved after feeding via an NG tube. An esophagogram at the local hospital suspected a tracheoesophageal fistula with a faint shadow of the fistulous tract, 2 centimeters above the clavicular level. With a high index of suspicion, the child was scheduled for a rigid tracheo-bronchoscopy. After the fistula, located 2 centimeters above the carina, was identified and catheterized, a transcervical division of the fistula was performed. The child had an uneventful postoperative course and could catch up with standard growth within six months of follow-up.
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![[TJS 46-3 05] Figure 3 Drawing pictures explaining the surgical anatomy of this patient. Through a transverse incision on the right neck above the clavicle, the esophagus was identified by retracting the right sternomastoid to the lateral side. The fistula could be identified by palpating the wire passed from the trachea to the esophagus. Note that the suture lines on the trachea and the esophagus were not in the exact alignment, which reduced the chance of recurrence.](https://he02.tci-thaijo.org/public/journals/683/submission_272270_56559_coverImage_en_US.jpg)
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