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Klouda TM, Lindholm E, Poletto E, Rani S, Varlotta L, Velasco J. Presentation of an H-type tracheoesophageal fistula in an adolescent male with cystic fibrosis: A case report and review of literature. Clin Imaging 2019; 60:38-47. [PMID: 31864198 DOI: 10.1016/j.clinimag.2019.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/27/2019] [Accepted: 11/18/2019] [Indexed: 11/15/2022]
Abstract
Congenital TEFs without esophageal atresia are rare but may occur more frequently than previously documented in literature. Careful history is required to suspect the diagnoses, as most patients will present with coughing associated with solid or liquids, recurrent unexplained pulmonary infections and complaints with eating. Some patients may show signs of chronic airway changes from recurrent aspiration pneumonia at the time of presentation. Diagnosis is challenging, with multiple imaging modalities including x ray, CT scan and esophogram able to identify a fistula. Surgery is required to improve quality of life and prevent chronic airway changes, and most cases repaired have no complications.
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Affiliation(s)
- Timothy M Klouda
- St. Christopher's Hospital for Children, Department of Pediatrics, Philadelphia, PA, United States of America.
| | - Erika Lindholm
- St. Christopher's Hospital for Children, Department of Pediatric Surgery, Philadelphia, PA, United States of America
| | - Erica Poletto
- St. Christopher's Hospital for Children, Department of Pediatric Radiology, Philadelphia, PA, United States of America
| | - Seema Rani
- St. Christopher's Hospital for Children, Department of Pediatric Pulmonology, Philadelphia, PA, United States of America
| | - Laurie Varlotta
- St. Christopher's Hospital for Children, Department of Pediatric Pulmonology, Philadelphia, PA, United States of America
| | - Jeanne Velasco
- St. Christopher's Hospital for Children, Department of Pediatric Pulmonology, Philadelphia, PA, United States of America
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Misra S, Behera BK, Mohanty MK, Sahoo SK. Diagnosis of inadvertent oesophageal intubation with H-type tracheo-oesophageal fistula. Br J Anaesth 2019; 122:e70-e71. [PMID: 30857614 DOI: 10.1016/j.bja.2019.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 01/07/2019] [Accepted: 01/07/2019] [Indexed: 01/25/2023] Open
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Aygun D, Emre S, Nepesov S, Tekant G, Cokugras H, Camcıoglu Y. Presentation of H-Type Tracheoesophageal Fistula in Two Adolescents: Delayed Diagnosis. Pediatr Neonatol 2017; 58:187-188. [PMID: 27324122 DOI: 10.1016/j.pedneo.2015.10.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 07/17/2015] [Accepted: 10/21/2015] [Indexed: 11/19/2022] Open
Affiliation(s)
- Deniz Aygun
- Department of Pediatric Infectious Diseases, Clinical Immunology and Allergy, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
| | - Senol Emre
- Department of Pediatric Surgery, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Serdar Nepesov
- Department of Pediatric Infectious Diseases, Clinical Immunology and Allergy, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Gonca Tekant
- Department of Pediatric Surgery, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Haluk Cokugras
- Department of Pediatric Infectious Diseases, Clinical Immunology and Allergy, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Yıldız Camcıoglu
- Department of Pediatric Infectious Diseases, Clinical Immunology and Allergy, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey
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Taira N, Kawasaki H, Atsumi E, Furugen T, Ichi T, Kushi K, Yohena T, Baba M, Kawabata T. A rare case of congenital bronchoesophageal fistula in an adult. Int J Surg Case Rep 2017; 36:182-184. [PMID: 28442319 PMCID: PMC5985245 DOI: 10.1016/j.ijscr.2017.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/18/2017] [Accepted: 03/18/2017] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION When congenital bronchoesophageal fistulas exist without atresia of the esophagus, the diagnosis can be delayed, although symptoms may occur early following fistula development. Therefore, while they are usually found in infants, they can be extremely rarely found in adults. We herein report a rare case of bronchoesophageal fistula without atresia in an adult. CASE An 69-year-old male presented to the outpatient clinic with a decades-long history of cough with expectoration immediately after taking food, especially liquids. Computed tomograph, esophagoscopy, and esophagography revealed the fistulous communication between the mid-esophagus and right lower lobe bronchus, with consolidation in the right lower lobe. We performed right lower lobectomy with the closure and excision of the fistula. The histopathology of the fistula revealed the mucosa to be lined by stratified squamous epithelium. There was no evidence of inflammation, granuloma, or carcinoma. CONCLUSION In conclusion, despite the benign nature of this malformation, if left untreated, it can cause long-term debilitating respiratory symptoms associated with the fistula. Therefore, the diagnosis should be considered in the evaluation of recurrent lung infection.
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Affiliation(s)
- Naohiro Taira
- Department of Surgery, National Hospital Organization, Okinawa National Hospital, Okinawa, Japan.
| | - Hidenori Kawasaki
- Department of Surgery, National Hospital Organization, Okinawa National Hospital, Okinawa, Japan
| | - Eriko Atsumi
- Department of Pathology, National Hospital Organization, Okinawa National Hospital, Okinawa, Japan
| | - Tomonori Furugen
- Department of Surgery, National Hospital Organization, Okinawa National Hospital, Okinawa, Japan
| | - Takaharu Ichi
- Department of Surgery, National Hospital Organization, Okinawa National Hospital, Okinawa, Japan
| | - Kazuaki Kushi
- Department of Surgery, National Hospital Organization, Okinawa National Hospital, Okinawa, Japan
| | - Tomofumi Yohena
- Department of Surgery, National Hospital Organization, Okinawa National Hospital, Okinawa, Japan
| | - Motoo Baba
- Department of Respiratory Medicine, Omotokai, Ohama Daiichi Hospital, Okinawa, Japan
| | - Tsutomu Kawabata
- Department of Surgery, National Hospital Organization, Okinawa National Hospital, Okinawa, Japan
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Salgaonkar HP, Sharma PC, Chhakarvarty N, Ramadwar R, Mehta R, Bhandarkar DS. Thoracoscopic repair of congenital tracheo-oesophageal fistula manifesting in an adult. J Minim Access Surg 2014; 10:204-6. [PMID: 25336822 PMCID: PMC4204265 DOI: 10.4103/0972-9941.141526] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 08/01/2014] [Indexed: 11/13/2022] Open
Abstract
Congenital trcheo-oesophageal fistula (TOF) without oesophageal atresia is usually diagnosed and managed in the neonatal period. Its presentation in adulthood is a rarity. Traditional treatment of a TOF in adults involves its repair via a thoracotomy. We report the case of a 23-year-old man diagnosed with an H-type TOF during workup undertaken for his symptoms of gastro-oesophageal reflux. This fistula located at the level of third thoracic vertebra was repaired successfully using a thoracoscopic approach.
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Affiliation(s)
| | - Pradeep Chandra Sharma
- Department of Minimal Access Surgery, Hinduja Hospital, Mahim, Mumbai, Maharashtra, India
| | - Nippun Chhakarvarty
- Department of Minimal Access Surgery, Hinduja Hospital, Mahim, Mumbai, Maharashtra, India
| | - Ravindra Ramadwar
- Department of Pediatric Surgery, Hinduja Hospital, Mahim, Mumbai, Maharashtra, India
| | - Rajiv Mehta
- Department of Gastroenterology, Liver Clinic, Surat, Gujarat, India
| | - Deepraj S Bhandarkar
- Department of Minimal Access Surgery, Hinduja Hospital, Mahim, Mumbai, Maharashtra, India
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Stavroulias D, Ampollini L, Carbognani P, Rusca M. Late presentation of congenital H-type tracheoesophageal fistula in an immunocompromised patient. Eur J Cardiothorac Surg 2011; 40:e98-100. [PMID: 21514835 DOI: 10.1016/j.ejcts.2011.03.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 03/11/2011] [Accepted: 03/15/2011] [Indexed: 11/18/2022] Open
Abstract
Congenital tracheoesophageal fistulas without esophageal atresia - H-type tracheoesophageal fistula - accounts for approximately 4% of esophageal malformations. This term refers to a connection at an oblique course between the posterior wall of the trachea and the anterior wall of the esophagus, presenting as an 'H' form. Typically, the diagnosis is made before the third year of life; however, some reports have been made of late presentation in adults who present chronic cough and frequent respiratory infections. Traditionally, surgery has been considered as the best treatment, depending on the level of the fistula. We present the case of an immunocompromised patient who was diagnosed as having a congenital tracheoesophageal fistula of the upper third of the trachea.
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Yasuda M, Hanagiri T, Ichiki Y, Takenoyama M, Sugio K, Yasumoto K. Congenital tracheoesophageal fistula in an elderly patient with thoracic empyema. Gen Thorac Cardiovasc Surg 2009; 57:622-4. [DOI: 10.1007/s11748-009-0450-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Accepted: 03/02/2009] [Indexed: 11/30/2022]
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Chung JH, Song SW, Ahn KR, Kim CS, Kang KS, Yoo SH, Chung JW, Koo JU. Tracheal intubation via esophagus in a patient with congenital tracheoesophageal fistula - A case report -. Korean J Anesthesiol 2009; 56:698-702. [DOI: 10.4097/kjae.2009.56.6.698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Jin Hun Chung
- Department of Anesthesiology and Pain Medicine, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Sang Woo Song
- Department of Anesthesiology and Pain Medicine, Bucheon Hospital, College of Medicine, Soonchunhyang University, Bucheon, Korea
| | - Ki Ryang Ahn
- Department of Anesthesiology and Pain Medicine, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Chun Sook Kim
- Department of Anesthesiology and Pain Medicine, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Kyu Sik Kang
- Department of Anesthesiology and Pain Medicine, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Sie Hyeon Yoo
- Department of Anesthesiology and Pain Medicine, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Ji Won Chung
- Department of Anesthesiology and Pain Medicine, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Ja Ug Koo
- Department of Anesthesiology and Pain Medicine, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
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