The modified Nadeem’s technique for the treatment of H-type tracheoesophageal fistula

Authors

  • Fatima Al Zahra Department of Pediatric Surgery, Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
  • Nadeem Akhtar Department of Pediatric Surgery, Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
  • Sana Khan Department of Pediatric Surgery, Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
  • Mohammed Abdulmomen Abdullah Saif Department of Pediatric Surgery, Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
  • Muhammad Umair Butt Department of Pediatric Medicine, Shifa College of Medicine, Islamabad, Pakistan
  • Ramsha Syed Department of Pediatric Surgery, Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan

DOI:

https://doi.org/10.18203/2349-3291.ijcp20212482

Keywords:

Tracheoesophageal, Fistula, Transfixation, Ligation

Abstract

An H-type fistula is an unusual category of the tracheoesophageal fistula to occur constituting only 5 % of all cases. The continuity of the esophagus leads to a delayed and vague presentation with a complaint of choking on feed and respiratory issues unlike the inability to feed and frothing soon after birth in other variants of tracheoesophageal fistula. We received a referred case of a 3-months-old male having recurrent respiratory tract infections and episodes of choking. After a thorough evaluation, a suspicion of H-type fistula was encountered that led to refined radiological evaluation. Contrast given per oral also delineated fistula and CT scan with intravenous and oral contrast revealed fistulous communication between two channels. Operated for H-type fistula through the modified Nadeem’s technique via a left cervical approach and discharged after uneventful recovery. The modified Nadeem’s technique via a left-sided cervical approach facilitates access, vision, and intervention easily as compared to the conventional right-sided approach given in the literature.

Author Biographies

Fatima Al Zahra, Department of Pediatric Surgery, Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan

Pediatric Surgery

Nadeem Akhtar, Department of Pediatric Surgery, Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan

Pediatric Surgery

Sana Khan, Department of Pediatric Surgery, Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan

Pediatric Surgery

Mohammed Abdulmomen Abdullah Saif, Department of Pediatric Surgery, Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan

Pediatric Surgery

Muhammad Umair Butt, Department of Pediatric Medicine, Shifa College of Medicine, Islamabad, Pakistan

Pediatric Medicine

Ramsha Syed, Department of Pediatric Surgery, Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan

Pediatric Surgery

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Published

2021-06-24

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Section

Case Reports