Transesophageal H-Type TEF Evaluation and Cannulation Using a Side-Viewing Flexible Endoscope: A Novel Technique for Guidewire Placement and Repair

Abstract Introduction: Congenital tracheoesophageal fistula without esophageal atresia (H-type TEF) is an unusual entity that typically presents in the first months of life with clinical signs of aspiration. Surgical repair is usually facilitated by placement of a catheter or wire through the fistula during rigid bronchoscopy.1,2 This cannulation allows the surgeon to identify the fistula during dissection of the neck.3 We describe a case of H-type TEF in which, the fistula could not be identified on rigid bronchoscopy, but was only visible on esophagoscopy. Cannulation of the fistula was therefore achieved using video esophagoscopy. The video depicts the placement of the guidewire under a video esophagoscope using an ultraslim (pediatric) side-viewing duodenoscope. Fluoroscopic images confirming fistula cannulation are also shown. The video runtime is 1:44. Materials and Methods: The patient is a male born prematurely at 34 weeks, birth weight 2.0 kg. Respiratory distress was noted on the first day of li...