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October 1967

Congenital Tracheoesophageal Fistula in the Adult

Author Affiliations

From Sinai Hospital of Detroit. Dr. Zack was formerly chief of the General Surgery Section, Darnall Army Hospital, Fort Hood, Tex. Doctor Owens is presently chief surgical resident, Sinai Hospital of Detroit.

Arch Surg. 1967;95(4):674-677. doi:10.1001/archsurg.1967.01330160144021

CONGENITAL tracheoesophageal fistula without atresia, "H" type, is a rare anomaly in children, accounting for only 3% of all congenital tracheoesophageal malformations,1 and rarer still in the adult, with only five cases reported in the literature to this time.2-6 Similarly, nonacquired bronchoesophageal fistula without atresia is also a rare occurrence, with upwards of 18 cases being reported.7 In those instances, more than 50% had associated bronchiectasis, and embryologically the multiple fistulous sites to various major and minor bronchi cannot be explained on the basis of a single disturbance in the separating mechanism of the trachea and esophagus.7 However, a single disturbance can explain the "H"-type tracheoesophageal fistula.8,9 It would appear, then, that the "H"-type tracheosophageal fistula occupies a more unique anomalous position in the adult.

Report of a Case  A 32-year-old Negro man was admitted to Darnall Army Hospital on June 13, 1966, with a

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