Simple method for confirmation of the presence of H-type tracheoesophageal fistula

ABSTRACT

Congenital H. type tracheoesophageal fistula presents with clinical features of variable types and severity including shocking, coughing and cynosis with feeds, pneumonia and abdomina distention. the rarity of the condition, its specific symptomatology and limitations in its demonstration by contrast radiology and endoscopy, contribute to delay between the first presentation and confirmation of the diagnosis. In this series of 8 patients, an initial esophagogram demonstrated the fistula in 4 only even after 2 attempts. By using methylene blue injected through an endotracheal tube with an esophagoscope inserted at the same time at the esophageal inlet, confirmed the presence of fistula and its position in all of them. This technique seemed to be simple and safe for confirmation of the presence of H. fistula when the clinical picture is highly suggestive, with negative esophagogram