<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec id="j_jmotherandchild.20202404.d-20-00004_s_006">
<h3>Background</h3>
<p>Congenital H-type tracheo-oesophageal fistula (H-TOF ) accounts for 4%–5% of all congenital tracheo-oesophageal malformations. We present our experience in managing 18 cases with congenital H-TOF at a tertiary institute over a 10-year period.</p></sec>
<sec id="j_jmotherandchild.20202404.d-20-00004_s_007">
<h3>Methods</h3>
<p>Records of all patients with congenital H-TOF managed from January 2009 to December 2018 in the Department of Paediatric Surgery at a tertiary institute were retrospectively analysed based on the age at presentation, gender, antenatal ultrasonography findings; birth history; details of previous hospitalisations, previous treatment details, presenting symptoms and associated anomalies; time to diagnosis; radiological investigations performed, bronchoscopy findings, intraoperative details, complications and postoperative follow-up.</p></sec>
<sec id="j_jmotherandchild.20202404.d-20-00004_s_008">
<h3>Results</h3>
<p>Totally 18 patients with congenital H-TOF were managed over a 10-year period. There were 12 females and six males. Six patients had associated anomalies. There was wide variation in age at the start of symptoms (3 days–4 years) and presentation/referral to us (15 days–12 years). Four patients were diagnosed to have H-TOF at first admission. The most common presenting symptom was recurrent pneumonias (n=18). Bronchoscopy was done in all patients, and fistula was diagnosed and cannulated before surgery. The fistula was present at C8–T1 in 14 patients. The median age at surgery was 12 months. In 17 patients, the fistula was repaired by the cervical approach. There were two deaths, and 16 patients are doing well on median follow-up of 8 years.</p></sec>
<sec id="j_jmotherandchild.20202404.d-20-00004_s_009">
<h3>Conclusion</h3>
<p>Congenital H-TOF should be considered in differential diagnosis while managing patients with recurrent lower respiratory tract infection and ‘coughing and choking episodes’; early diagnosis and management of the associated H-TOF is important for improved survival and outcome.</p></sec>

</abstract>

Background
Congenital H-type tracheo-oesophageal fistula (H-TOF ) accounts for 4%–5% of all congenital tracheo-oesophageal malformations. We present our experience in managing 18 cases with congenital H-TOF at a tertiary institute over a 10-year period.

Methods
Records of all patients with congenital H-TOF managed from January 2009 to December 2018 in the Department of Paediatric Surgery at a tertiary institute were retrospectively analysed based on the age at presentation, gender, antenatal ultrasonography findings; birth history; details of previous hospitalisations, previous treatment details, presenting symptoms and associated anomalies; time to diagnosis; radiological investigations performed, bronchoscopy findings, intraoperative details, complications and postoperative follow-up.

Results
Totally 18 patients with congenital H-TOF were managed over a 10-year period. There were 12 females and six males. Six patients had associated anomalies. There was wide variation in age at the start of symptoms (3 days–4 years) and presentation/referral to us (15 days–12 years). Four patients were diagnosed to have H-TOF at first admission. The most common presenting symptom was recurrent pneumonias (n=18). Bronchoscopy was done in all patients, and fistula was diagnosed and cannulated before surgery. The fistula was present at C8–T1 in 14 patients. The median age at surgery was 12 months. In 17 patients, the fistula was repaired by the cervical approach. There were two deaths, and 16 patients are doing well on median follow-up of 8 years.

Conclusion
Congenital H-TOF should be considered in differential diagnosis while managing patients with recurrent lower respiratory tract infection and ‘coughing and choking episodes’; early diagnosis and management of the associated H-TOF is important for improved survival and outcome.

Congenital H-type tracheo-oesophageal fistula: An institutional review of a 10-year period

Journal of Mother and Child

This work is licensed under the Creative Commons Attribution 4.0 International License.

Background
Congenital H-type tracheo-oesophageal fistula (H-TOF ) accounts for 4%–5% of all congenital tracheo-oesophageal malformations. We present our...

Presenting symptoms		No. of patients
Respiratory symptoms	Recurrent pneumonias	18
	Bouts of coughing and choking after feeds	16
	Cyanosis	8
Failure to thrive		14
Abdominal symptoms	Abdominal distension	6
	Constipation	8

Total patients with H-TOF	18 out anomalies of total oesophageal (4.2%)
Age at presentation/referral (n=18)	<1 year	11
	1–3 years	4
	3–6 years	2
	6–12 years	0
	>12 years	1
Gender distribution (n=18)	Males	6
	Females	12
Number of previous hospitalisations (n=18)	1	8
	2	4
	3	5
	>3	1
Associated anomalies (n=6)	ASD	3
	VSD and PDA	1
	Renal agenesis	1
	Radial agenesis	1

Congenital H-type tracheo-oesophageal fistula: An institutional review of a 10-year period

Article Category: Original article

Published Online: Jul 13, 2021

Page range: 2 - 8

DOI: https://doi.org/10.34763/jmotherandchild.20202404.d-20-00004

Keywords
congenital, fistula, H-type, trachea-oesophageal

© 2021 Charu Tiwari et al. published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Overlapping reasons for previous hospitalisations in all patients with H-TOF

Demographic characteristics of all 18 patients with H-TOF

Congenital H-type tracheo-oesophageal fistula: An institutional review of a 10-year period

Article Category: Original article

Published Online: Jul 13, 2021

Page range: 2 - 8

DOI: https://doi.org/10.34763/jmotherandchild.20202404.d-20-00004

Keywordscongenital, fistula, H-type, trachea-oesophageal

© 2021 Charu Tiwari et al. published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Overlapping reasons for previous hospitalisations in all patients with H-TOF

Demographic characteristics of all 18 patients with H-TOF

Keywords
congenital, fistula, H-type, trachea-oesophageal