Double H-type Tracheoesophageal Fistulae: A Case Report

We present an extremely rare case with double H-type tracheoesophageal fistulae identified with a time-lapse and repaired separately. A newborn male presented with cyanosis after breastfeeding. Contrast esophagogram demonstrated an H-type fistula, and then it was repaired in a standard fashion via right thoracotomy. When routine esophagogram was taken on postoperative day 10, another fistula was noticed at a level higher than the previous one. Bronchoscopy was performed to evaluate the lesion whether it was a recurred fistula or a second H-type fistula. However, it was so tiny that it was not visible with bronchoscopy. It was discovered only two months later when the fistula had grown up with the baby. The second H-type fistula was repaired through a cervical incision. Although double H-type fistulae are extremely rare, the possibility of another fistula, as well as recurrence, must be ruled out when symptom recurs after a definitive operation of an H-type fistula.