Congenital Tracheoesophageal Fistula in the Adult

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