Abstract
A neonate was operated upon for esophageal atresia with distal tracheo oesophageal fistula. He developed mediastinitis due to an anastomotic leak, which led to a fatal outcome. At autopsy, an associated hypertrophic pyloric stenosis was found. This had probably contributed to the development of the leak. The condition had been suspected in the post operative period, but had not been further investigated. A review of the literature shows a high incidence of anomalies associated with tracheoesophageal fistula. In patients of tracheo oesophageal fistula, in whom associated gastro-intestinal anomalies are suspected, contrast radiographic studies to include the pylorus, stomach and duodenum are mandatory. A formal laparotomy and surgical correction must then follow, if required. A high index of suspicion is required so as to avoid complications arising from a delay in complete diagnosis.
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