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Title: REAPPRAISAL OF A SIMPLE METHOD FOR DIAGNOSIS AND LEVELING OF ISOLATED TRACHEOESOPHAGEAL FISTULA
Author(s): Sherif M. Soliman, Gamal S. Ali, Sameh A. Hay
Source: The Egyptian Journal of Neonatology, 2001, Vol. 2, No. 1,,

Abstract: Purpose:The diagnosis of isolated (N-type) tracheoesophageal fistula (TEF) remains a challenging problem, requiring in most instances a combination of various diagnostic modalities to establish its presence as well as its level. With paucity of bronchoscopic facilities, we adopted a simple technique for diagnosing and leveling of isolated TEF. Methods:From 1990 through 1999, 11 patients with clinically suspicious isolated TEF were subjected to esophagoscopy with simultaneous endotracheal injection of Methylene Blue and application of positive pressure. The efflux of the dye to the esophagus was noted and its level was recorded. All patients with TEF underwent surgical correction. Results:Among 11 patients (age range 3weeks – 9 months) with clinically suspicious isolated TEF, esophagography / cineradiography detected the presence of the fistula in 4 patients. Endotracheal injection of Methylene blue with simultaneous esophagoscopy confirmed the presence of the fistula and its level in 8 and 3 were negative. In positive cases, fistulae were located in the cervical esophagus. With a Left Cervical approach, fistulae in all patients were identified, divided and closed with seven survivors. One had a recurrent fistula necessitating re-operation and closure with an intervening muscle flap. Conclusion:This technique is simple and effective in diagnosing and leveling of isolated TEF. In our experience it is found to be a suitable alternative when bronchoscopic facilities are not available...

Addresses: Pediatric Surgery department, Children’s Hospital Institute of postgraduate childhood study- Ain Shams University Cairo – Egypt...

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Country Code: EG