H- type tracheoesophageal fistula in a child presenting as recurrent cough

H-type of tracheoesophageal fistula (TEF) is a rare congenital malformation presenting during infancy with choking and recurrent pneumonia. We present a case of H-type TEF with intermittent nonspecific cough, diagnosed on oesophagogastroscopy and upper gastrointestinal contrast study. She was operated at the age of 30 months

Survival outcomes of trachea esophageal fistula in infant

Background: Tracheo-esophageal fistula (TEF) is a rare congenital abnormality often associated with several other anomalies including renal, vertebral column, gastrointestinal or cardiovascular defects. This study was carried out to evaluate the outcome of trachea esophageal fistula among patients who underwent various surgeries for the anastomosis of trachea esophageal fistula.Methods: This study was conducted as a record based cross sectional study among 88 patients who were diagnosed and treated for trachea-esophageal fistula in tertiary care hospital between 2015 and 2018. Data regarding the type of anomaly, presence of associated anomalies, type of surgery and outcomes were documented. Findings of echocardiography and ultrasonography were also documented. Data was analyzed using SPSS software. Chi square test was used to evaluate the outcome of the surgical procedures for management of TEF.Results: Majority of the participants in our study belong to <1 month of age and were males (56.8%). Type 3 tracheo esophageal fistula (80.7%) was the most common type. Associated cardiovascular anomalies were present in 50% of the participants. Thoracotomy with TEF repair was most preferred surgery (76%). Present study demonstrated that surgical techniques improve the physical and physiological outcome of the patients (p <0.05).Conclusions: Trachea esophageal fistula needs to be corrected with surgical procedure. Modern techniques like thorocoscopic anastomosis, thorocosopic techniques to achieve an anastomosis can also be explored. Future studies may be directed in detecting congenital anomalies during the pre-natal period with the help of genetic techniques.

A Case of Delayed Tracheo-esophageal Fistula Complicating Acute Intoxication of Hydrogen Peroxide

Hydrogen peroxide is a commonly used oxidizing agent. If injected, it may result in morbidity via direct caustic injury, oxygen gas formation, and lipid peroxidation. We report a 40-year-old male patient who accidentally swallowed undiluted hydrogen peroxide (35%). The initial chest computed tomography scan showed no active lesions. He was admitted to the intensive care unit for conservative treatment. Fourteen days after treatment, uncontrolled fever and foul oder sputum occurred, which was not alleviated despite empirical antibiotics therapy. Findings on a chest computed tomography showed tracheo-esophageal fistula at the lower trachea and left main bronchus. He underwent surgical replacement surgery and was discharged without complication after 52 days of admission.

Long-term Complications of Congenital Esophageal Atresia –Single Institution Experience.

Objective: To evaluate general health condition of children operated for esophageal atresia, including complications from gastrointestinal tract and skeletal defects. Methods: Between 1990 and 2005, 77 patients were operated for esophageal atresia in the Polish Mother’s Health Memorial Hospital. The study was based on retrospective analysis of medical case records of all children with esophageal atresia. All living patients (n=51) were invited for follow-up studies. Results: Pathological gastroesophageal reflux was found in 46.7% of children. Scoliosis was diagnosed in 20 patients. Chest deformations were observed in 43.3% children Conclusion: The absence of clinical symptoms does not exclude the presence of gastroesophageal reflux in children operated for esophageal atresia. Children operated for esophageal atresia should be followed up regularly by a multispecialistic medical team.

Tracheal agenesis with broncho-esophageal fistula in VACTERL / TACRD association.

Tracheal agenesis (TA) is an extremely rare malformation. We report here autopsy findings in a case of TA with bronchoesophageal fistula of Floyd type III. The other malformations present included laryngeal atresia, Right lung hypolobulation, ventricular septal defect in membranous portion, bilateral cystic renal dysplasia, spleninculus, Meckel's diverticulum, and imperforate anus. The constellations of malformations present in our case have overlapping features with Vertebral anomalies, Anal atresia, Cardiovascular anomalies, Tracheo-esophageal fistula, Esophageal atresia, Renal anomalies, Limb anomalies and Tracheal atresia or laryngo tracheal atresia, Cardiac anomalies, Renal anomalies, Duodenal atresia association described previously in the literature.

Corrosive Tracheo-esophageal Fistula Following Button Battery Ingestion.

We describe a case of corrosive tracheo-esophageal fistula following button battery ingestion in a 1-year old nonverbal pediatric patient. The delay in diagnosis was caused by failure to obtain correct history and failure to detect opacity of the battery in the neck at the first visit. The large fistula was successfully treated with division and repair with non absorbable sutures, with interposition of strap muscles between separated trachea and esophagus.

Anesthesia management in operation on patients with congenital esophageal atresia accompanying tracheo-esophageal fistula / 重庆医科大学学报

Objective:To probe the anesthesia methods and management of respiration in the operation on congenital esophageal atresia accompanying tracheo-esophageal fistula.Methods:Retrospective analysis was used to study anesthesia process during operation of 9 cases.Results:Vital signs of 7 cases during operation were stable.No increased airway resistance or bronchospasm was observed.Seven patients who received endotracheal intubation and controlled respiration after slow induction developed no significant atelectasis or more severe pneumonia on post -operation X-ray.Stomach gassiness happened in two patients who received fast induction.Gradually increased airway resistance was observed and more severe pneumonia accompanying atelectasis happened in the two patients.No hypothermia happened among these 9 patients owning to right keeping warm.Seven patients were discharged in good health.The families of two patients gave up treatment.Conclusion:Pulmonary complication can be reduced effectively and the same stable anesthesia can be obtained by combining the existing autonomous breath after slow induction with controlled breath after blocking up fistula cannula.The effective aspiration,keeping warm, intensive transfusion and consummate analgesia during and after the operation are very important to guarantee the security for patients.

Four Cases of Congenital Esophageal Stenosis Due to Tracheobronchial Remnants

Esophageal stenosis due to tracheobronchial remnants is a rare cause of congenital esophageal stenosis. The cause is thought to be esophageal sequestration of tracheobronchial remnants during embryonic separation. Errors in diagnosis are common and high index of suspicion is required for accurate diagnosis, and resection of primary site with anastomosis is recommanded. Although a rare entity, esophageal stenosis due to tracheobronchial remnants should be considered in patients with esophageal stenosis, when esophageal stenosis fails to respond to standard therapy including bougienage and balloon dilatation, and esophagoscopy shows normal mucosa on the stenotic segment. Four cases of congenital esophageal stenosis due to tracheobronchial remnants were reported, the first case without accompanied anomaly, the second case accompanied by tracheoesophageal fistula, the third case accompanied by Down syndrome, and the last case accompanied by tracheoesophageal fistula and congenital heart disease.

Tracheal Agenesis: Report of an autopsy case

Tracheal gaenesis is an extremely rare congenital anomaly and is characterized by totally or partially undeveloped trachea. In many instances, the lesion has been associated with malformations in other organ systems. This anomaly is classified into 3 types based on developmental period of the respiratory tract. We report a case of tracheal agenesis with tracheoesophageal fistula in a 2-hour-old male. Postmortem examination revealed that the upper and mid portion of the trachea was absent but 1 cm segment of the trachea above the carina was present. The proximal end to this trachea opened to the esophagus by a fistula, 1 cm in diameter. The well-formed larynx ended blindly in a fibrous sac at which thyroids and cartilage islands are noted. Associated anomalies were bilobed right lung and single umbilical artery.