Vatansever Ulfet, Acunaş Betül, Salman Tansu, Altun Gülay, Duran Ridvan
Department of Pediatrics, Trakya University, Faculty of Medicine, Edirne, Turkey.
Clin Nucl Med. 2006 Aug;31(8):451-3. doi: 10.1097/01.rlu.0000226898.53461.90.
Congenital tracheoesophageal fistula (TEF) without esophageal atresia is commonly known as "H" type. This is extremely rare in infants. The rarity of the condition, its nonspecific symptomatology, and limitations in its demonstration by contrast radiology and endoscopy contribute to delays between first presentation and confirmation of the diagnosis. Our aim was to demonstrate a congenital H-type tracheoesophageal fistula by using Tc-99m sulfur colloid scintigraphy.
A case report.
A preterm female infant was born by cesarean section at 34 weeks gestation. After many attempts of feeding, she developed apnea, resolving spontaneously, peroral cyanosis, pallor, hypersalivation, and abdominal distension, even when she was being fed by an orogastric tube. With this complex symptomatology, she was suspected to have an H-type TEF. Because of prematurity and recurrent respiratory problems of the infant and the high risk of aspiration of contrast material during a cineradiographic procedure, and also because of the invasive nature of the endoscopic procedure as well as the requirement of general anesthesia, the diagnosis was made by using Tc-99m sulfur colloid scintigraphy and confirmed at operation.
Demonstrating a congenital H-type tracheoesophageal fistula by using radionuclide imaging is an easily applicable technique.
先天性食管气管瘘（TEF）无食管闭锁通常被称为“H”型。这在婴儿中极为罕见。该病的罕见性、非特异性症状以及造影放射学和内镜检查在显示上的局限性导致首次就诊与确诊之间存在延迟。我们的目的是利用锝-99m硫胶体闪烁显像来显示先天性H型食管气管瘘。
病例报告。
一名早产女婴在妊娠34周时剖宫产出生。经过多次喂养尝试，她出现呼吸暂停，可自行缓解，口周发绀、面色苍白、流涎过多以及腹胀，即使通过口胃管喂养时也是如此。鉴于这种复杂的症状表现，怀疑她患有H型TEF。由于婴儿早产且反复出现呼吸问题，以及在电影造影检查期间造影剂误吸的高风险，同时也由于内镜检查具有侵入性以及需要全身麻醉，通过锝-99m硫胶体闪烁显像做出诊断，并在手术中得到证实。
利用放射性核素显像显示先天性H型食管气管瘘是一种易于应用的技术。
