Fits of Coughing on Feeding (Differential Diagnosis)

regu_13a_n.jpg: Contrast esophagography in a 12-day-old girl with fits coughing and suffocation on feeding. Two parallel proceeding structures with a coat of contrast corresponding to the trachea (on the left) and to the esophagus (on the right) are recognizable. In addition, a peaked process which runs from the esophagus in an oblique direction to the trachea !£regu_13a_p£!. regu_13b_n.jpg: Operative findings following a cervical supraclavicular incision. The right main carotic artery is marked with a red and the esophagus with two white strings. In addition, a structure proceeding from the esophagus is marked with a green string !£regu_13b_p£!. regu_13a_n.jpg and regu_13b_n.jpg: The diagnosis is an isolated tracheoesophageal fistula which is a special type of congenital esophageal atresia. In contrast to the latter pathology with seeming vomiting of saliva and erroneously fed tea which is in fact a regurgitation, an isolated tracheoesophageal fistula (N-fistula) may be diagnosed delayed; due to the possible delay in time and the difficulties in feeding, an isolated tracheoeophageal fistula may be a differential diagnosis of hypertrophic pyloric stenosis. The structure proceeding from the esophagus which is marked by a green string is a relatively broad N-fistula.