“H” type tracheoesophageal fistula associated with cardiac and vertebral defects: management challenges at our institute – A case report with literature review

The “H” type tracheoesophageal fistula (H-TEF) is a rare, isolated congenital anomaly with an incidence of 4–5%, and it is rarely associated with other congenital conditions. Both diagnosis and surgical identification of this condition can be challenging. In most reported cases, the diagnosis was based on clinical suspicion. We present the case of a 1-year and 9-month-old male child who had regurgitation of feeds from the nose and mouth since birth, coughing after each feed, and failure to thrive. Additionally, the child had a small ventricular septal defect and gait abnormalities, including scoliosis due to butterfly vertebrae. The diagnosis was made through clinical presentation, a high index of suspicion, and fiberoptic bronchoscopy. Surgical management involved cannulating the fistula before ligation via a transcervical approach, though the initial attempt at cannulation was unsuccessful. A review of the literature is included, focusing on the clinical presentation of H-TEF, diagnostic methods, and treatment options. Early diagnosis and treatment of H-TEF can lead to symptom resolution, weight gain, and improved respiratory function.