Esophageal Atresia With H-Type Tracheo-Esophageal Fistula

  • Etiology: congenital
  • UGI: to diagnose requires forceful contrast injection through feeding tube using pullback technique with patient in left lateral and left anterior oblique positions starting in the distal esophagus, false negative UGIs are common
  • Clinical: third most common (4%) esophageal atresia, diagnosis often delayed, may present with recurrent aspiration pneumonias, less associated with other anomalies

Radiology Cases of Esophageal Atresia With H-Type Tracheo-Esophageal Fistula

2 lateral images from an upper GI shows contrast in the esophagus as expected (posteriorly) and in the airway unexpectedly (anteriorly). An H-type fistula is clearly seen connecting the airway and the esophagus.
CXR shows diffuse infiltrates in the right upper and lower lobes and hyperexpansion. An upper GI showed a fistula between the esophagus and trachea.