Ch. Amith Kumar^a, Ch. Rakesh^b, Ch. Sahay^c

^aAssistant Professor, ^b Post graduate student, ^c Senior resident, Department of Pediatrics, Prathima Institute of Medical Sciences, Karimnagar , Andhra Pradesh, India.

Address for correspondence

Dr. Ch. Rakesh, Post graduate student, Department of Pediatrics, Prathima Institute of Medical Sciences, Karimnagar , Andhra Pradesh, India.

Email: : rakesh.challagulla@gmail.com

Tracheo esophageal fistula without an associated esophageal atresia (H – variant) is one of the rare anomalies (incidence being 4.2%). According to the American academy of pediatrics survey which was done in 1964, 1058 cases of tracheoesophageal fistula cases reported out of which only 4.2% were tracheoesophageal fistula without any esophageal atresia. Most of the cases were mis-diagnosed during neonatal period and were treated as pneumonia. In a large survey done by Killen and Greenle in 1965 it has been reported that the diagnosis was made within the first month of life in 43% and with in first year in 83%. We report a case of tracheo esophageal fistula where diagnosis was missed on day one of admission as naso-gastric tube was passed in to stomach with out difficulty and child was treated for respiratory distress. Diagnosis was made on day two as there was excessive pooling of secretions, there was coiling and difficulty in passing nasogastric tube. As respiratory distress did not subside, a repeat chest xray plain was taken which confirmed coiling of the naso gastric tube. Diagnosis was confirmed by contrast (gastro graphin) x-ray taken at different time intervals. In this child there were no any other systemical or physical anomalies noted.

Key Words: Naso-gastric tube, tracheaesophageal fistula, Gastro graphin, transanastomotic tube.