Abstract
H-type tracheoesophageal fistula is a rare congenital anomaly that is seldom diagnosed in the neonatal age. Documenting it and then locating it at surgery are both difficult. A case is presented to highlight the diagnostic and therapeutic utility of trans-fistula guidewire placement.
Highlights
H-type tracheoesophageal fistula (H-TEF) is a rare, life-threatening congenital anomaly, which accounts for 4- 5% of all esophageal atresias/ tracheoesophageal fistula (EA/TEF). [1,2] The clinical features are variable, but the commonest are recurrent respiratory symptoms, aspiration with cyanosis during feeding, and abdominal distension
Endoscopic management using fibrin occlusion, sclerosation, electrocautery, laser coagulation has a lower morbidity and mortality rate compared to the surgical approach,[7] but is associated with Journal of Neonatal Surgery Vol 3(3); 2014
Many surgeons nowadays recommend preoperative or intraoperative bronchoscopic guidewire trans-fistula placement.[3,4,5]. This strategy has several advantages. Such a wire can be passed through a flexible bronchoscope, and it can be identified on a chest roentgenogram so we can verify the exact location of the fistula
Summary
H-type Tracheoesophageal Fistula in a Newborn: Determining the Exact Position of Fistula by Intra-operative Guidewire Placement.
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