A premature infant with h-type tracheoesophageal fistula demonstrated by scintigraphic technique.
OBJECTIVE
Congenital tracheoesophageal fistula (TEF) without esophageal atresia is commonly known as "H" type. This is extremely rare in infants. The rarity of the condition, its nonspecific symptomatology, and limitations in its demonstration by contrast radiology and endoscopy contribute to delays between first presentation and confirmation of the diagnosis. Our aim was to demonstrate a congenital H-type tracheoesophageal fistula by using Tc-99m sulfur colloid scintigraphy.


METHODS
A case report.


RESULTS
A preterm female infant was born by cesarean section at 34 weeks gestation. After many attempts of feeding, she developed apnea, resolving spontaneously, peroral cyanosis, pallor, hypersalivation, and abdominal distension, even when she was being fed by an orogastric tube. With this complex symptomatology, she was suspected to have an H-type TEF. Because of prematurity and recurrent respiratory problems of the infant and the high risk of aspiration of contrast material during a cineradiographic procedure, and also because of the invasive nature of the endoscopic procedure as well as the requirement of general anesthesia, the diagnosis was made by using Tc-99m sulfur colloid scintigraphy and confirmed at operation.


CONCLUSIONS
Demonstrating a congenital H-type tracheoesophageal fistula by using radionuclide imaging is an easily applicable technique.
Vatansever
Ulfet
U
Department of Pediatrics, Trakya University, Faculty of Medicine, Edirne, Turkey. uvatansever@trakya.edu.t
Acunaş
Betül
B
Salman
Tansu
T
Altun
Gülay
G
Duran
Ridvan
R
D005260:Female; D015902:Gamma Cameras; D005772:Gastrointestinal Transit / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008168:Lung / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid; D014138:Tracheoesophageal Fistula / Q000000981:diagnostic imaging*
D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid