Recurrent Aspiration Pneumonia in a Missed Case of Broncho-Esophageal Fistula with Repaired Esophageal Atresia: Usefulness of Fiberoptic Bronchoscopy: A Case Report

Broncho-esophageal fistula (BEF) is a rare congenital anomaly affecting the respiratory and upper gastrointestinal tract. The rarity makes its timely diagnosis very challenging. This study presents a rare case of missed congenital BEF in a six-year-old girl with repaired esophageal atresia in the neonatal period suffering from recurrent respiratory symptoms, choking, and respiratory distress following eating, resulting in vomiting or regurgitation for three years before admission. While the contrast esophagography and endoscopy had failed to diagnose her problem, the methylene blue test via an esophageal catheter observed by fiberoptic bronchoscopy could detect the presence of BEF reliably in the present case. Presenting this case can raise physicians’ knowledge of the diagnostic role of methylene blue test via fiberoptic bronchoscopy.