Case Report
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World J Clin Cases. Jul 16, 2014; 2(7): 309-310
Published online Jul 16, 2014. doi: 10.12998/wjcc.v2.i7.309
Passage of nasogastric tube through tracheo-esophageal fistula into stomach: A rare event
Ravikiran Shankar Kamble, Rahulkumar Gupta, Abhaya Gupta, Paras Kothari, K Vishesh Dikshit, Krishnakumar Kesan, Kedar Mudkhedkar
Ravikiran Shankar Kamble, Rahulkumar Gupta, Abhaya Gupta, Paras Kothari, K Vishesh Dikshit, Krishnakumar Kesan, Kedar Mudkhedkar, Department of Pediatric Surgery, Lokamany Tilak Municipal Medical College and Government Hospital, Maharashtra 400022, India
Author contributions: Kamble RS, Gupta R and Gupta A evaluated the patient and performed the surgery and compiled the manuscript; Kothari P guided for surgery and follow up; Dikshit KV and Mudkhedkar K collected data; Kesan K edited the manuscript.
Correspondence to: Dr. Ravikiran Shankar Kamble, Department of Pediatric Surgery, Lokamany Tilak Municipal Medical College and Government Hospital, Sion, Mumbai, Maharashtra 400022, India. drkambleravi80@gmail.com
Telephone: +91-22-24042190
Received: February 16, 2014
Revised: May 14, 2014
Accepted: May 28, 2014
Published online: July 16, 2014
Processing time: 154 Days and 10.4 Hours
Abstract

Esophageal atresia with tracheo-oesophageal fistula (TEF) occurs in 1 in 3500 live births. Anorectal malformation is found to be associated with 14% of TEF. Esophageal atresia with TEF is a congenital anomaly which classically presents as excessive frothing from the mouth and respiratory distress. Rarely gastric position of the feeding tube in a case of TEF can be obtained delaying the diagnosis of TEF. We had an uncommon situation where a nasogastric tube reached the stomach through the trachea and tracheo-esophageal fistula, leading to misdiagnosis in a case of esophageal atresia with tracheoesophageal fistula. By using a stiff rubber catheter instead of a soft feeding tube for the diagnosis of esophageal atresia and TEF, such situation can be avoided.

Keywords: Esophageal atresia; Tracheoesophageal fistula; Nasogastric tube; Red rubber catheter; Misdiagnosis

Core tip: Esophageal atresia with tracheoesophageal fistula is congenital anomaly which presents as excessive froathing from mouth and respiratory distress. It can be suspected when a nasogastric tube difficult to insert into stomach or radiographically presence coiled nasogastric tube in pharynx. We had an uncommon situation where a nasogastric tube reached the stomach through the trachea and tracheo-esophageal fistula, leading to misdiagnosis in a case of esophageal atresia with tracheoesophageal fistula. Similar clinical situations can be avoided by using a stiff rubber catheter instead of a soft feeding tube for the diagnosis of esophageal atresia and tracheo-oesophageal fistula.