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J Thorac Cardiovasc Surg 2004;128:316-318
© 2004 The American Association for Thoracic Surgery

Brief communication

Congenital tracheoesophageal fistulas presenting in adults: Presentation of two cases and a synopsis of the literature

^a Department of Thoracic Surgery, Freeman Hospital, Newcastle upon Tyne, United Kingdom
^b Department of Thoracic Surgery, The Royal Brompton Hospital, London, United Kingdom

Received for publication November 9, 2003; accepted for publication December 16, 2003.

^* Address for reprints: Joseph Zacharias, FRCS (CTh), 45 Daylesford Dr, Castledene, Newcastle upon Tyne, United Kingdom NE3 1TW
josephzacharias@hotmail.com

The first 20% of the full text of this article appears below.

More than 98% of tracheoesophageal fistulas (TEFs) are associated with atresia of the esophagus.¹ These appear in the neonatal period, and early surgical treatment provides a satisfactory result. In the group in which a fistula is not associated with atresia, termed H-type fistula, symptoms might be minimal, and presentation might be delayed until adulthood. We report a single surgeon's experience of 2 patients with this unusual condition. Bronchoesophageal fistulas are more commonly reported, with more than 140 such cases detailed in the literature.² We have reviewed and summarized the 14 reports in the English literature of congenital TEFs presenting in adults.

Clinical summary

PATIENT 1. A 45-year-old female nonsmoker had a recurrent productive cough. It was worse over the past 2 years and was particularly troublesome at night. Examination with a fiberoptic bronchoscope showed a punctum in the posterior wall of the trachea 3.5 cm from the carina (Figure 1). No fistula was identified on barium swallow or esophagoscopy. A cine contrast study done while the patient was in the prone position confirmed the fistula between the esophagus and the lower trachea. . . . [Full Text of this Article]

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