Early diagnosis and treatment of tracheoesophageal fistula in a newborn: A case report

Tracheoesophageal fistula (TEF) is an extremely rare congenital anomaly in newborns. In this case, we emphasize the role of contrast tube esophagography in diagnosing TEF and highlight how intraoperative guidewire placement facilitated fistula localization during surgical exploration. A female newborn was admitted to the neonatal intensive care unit due to respiratory distress and wheezing. Her condition deteriorated on day 4, necessitating endotracheal intubation and mechanical ventilation. Despite treatment for congenital pneumonia, intermittent respiratory distress persisted. On day 23, TEF was confirmed via contrast esophagography. At 25 days of age, the patient underwent rigid esophagoscopy, which confirmed the presence of TEF. A guidewire was advanced through the fistula to aid in its localization, allowing for precise surgical repair. This case underscores the challenges associated with diagnosing H-type TEF in neonates and highlights the crucial role of contrast esophagography and intraoperative guidewire placement in optimizing surgical management.

Keywords: Esophageal atresia, esophagogram, neonatal surgery, newborn, tracheoesophageal fistula.