Near-missed upper tracheoesophageal fistula in esophageal atresia

Gideon Shoshany, Arkadi Vatzian, Anat Ilivitzki, Tatiana Smolkin, Fahed Hakim, Imad R. Makhoul

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Upper pouch tracheoesophageal fistula (TEF) accompanying esophageal atresia (EA) occurs in less than 1% of all EA/TEF variants and could be easily missed after birth. To confront such diagnostic inaccuracy, perioperative tracheobronchoscopy (TBS) and preoperative upper pouch esophagogram (UPEG) have been proposed but are still controversial. We describe the role of UPEG and TBS, used early after birth, in two cases of EA/TEF with upper pouch TE fistulas with unusual high location (one intrathoracic, one subglotic). These upper TE fistulas were almost missed but ultimately detected very early while employing both UPEG and TBS, wherein UPEG was for the diagnosis of TEF and TBS for both intraoperative diagnostic confirmation and aid in TEF identification. We conclude that UPEG and TBS are complementary in detecting near-missed upper TE fistula accompanying EA. Such approach ensures early and accurate diagnosis of EA/TEF variants, thus preventing the complications of a missed congenital upper pouch TE fistula.

Original languageEnglish
Pages (from-to)1281-1284
Number of pages4
JournalEuropean Journal of Pediatrics
Issue number10
StatePublished - Oct 2009
Externally publishedYes


  • Bronchoscopy
  • Esophageal atresia
  • Esophagogram
  • Tracheoesophageal fistula


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