Congenital tracheoesophageal fistulas are not common. This is fortunate, for a child so afflicted rarely lives longer than a month after birth, usually succumbing within a few days. The condition is invariably accompanied by esophageal atresia, either above or below the stricture.
The fistula that was found and eventually closed in the patient considered in this report was about ½ inch (1.3 cm.) long and located in the party wall of the trachea and esophagus. It was opposite the ends of the third, fourth and fifth tracheal rings. It was slitlike in appearance and a trifle to the left of the sagittal plane.
At the beginning of the act of swallowing it was closed, but as the larynx receded there was dilatation of the opening, which could be seen from the tracheal side. There was a partial diaphragm of muscle and mucous membrane on the esophageal side, so that when