Congenital H-type tracheoesophageal fistula complicated by achalasia in an adult: report of a case.

A young adult with a congenital H-type tracheoesophageal fistula complicated by achalasia of the esophagus presented with complaints consistent with existing long-standing asthma. Only on direct questioning were esophageal aspects elicited. This combination of conditions proved difficult to diagnose even though suspected. Esophageal x-ray in the prone-oblique position proved valuable in the diagnosis and localization of the fistula. Correction of the obstruction of achalasia preceded fistula repair. Fistula repair involved sleeve resection of the trachea, with tracheal anastomosis after closure of the esophageal defect.