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H type tracheoesophageal fistula (TEF) is a very uncommon congenital entity. Diagnosis of these cases are usually delayed and cases are treated as respiratory tract infections. We here reporting a four years old girl, presented to us with recurrent respiratory tract infection. On examination of baby decreased chest movement, and on auscultation of chest there was decreased breath sounds on left side was found. Chest X rays suggest esophagus was grossly dilated, and air filled. Contrast esophagogram suggestive of H type tracheoesophageal fistula and bronchiectasis changes on left lung. Contrast Enhanced Computer Tomography suggest bronchiectasis changes on left lung. The diagnosis of H type tracheoesophageal fistula (TEF) was made by rigid bronchoscopy. Successful surgical repair of H type TEF required right thoracotomy approach as fistula was quite low laying. Tracheo-bronchoscopy (especially rigid) is an important investigation due to the better visualization, in doubtful cases and to locate the exact location of fistula. H type TEF above T2 should be approached through cervical approach whereas lower fistula should be always approached by right posterolateral thoracotomy. Low laying fistula is extremely rare finding along with bronchiectasis changes in left lung. Therefore, this case report describes a rare case and review of literature.

Isolated left lung bronchiectasis: a rare presentation of H type tracheoesophageal fistula