Saudi Journal of Gastroenterology
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Year : 2012  |  Volume : 18  |  Issue : 2  |  Page : 151-152
Megaesophagus in the pediatric age group: A diagnostic dilemma

Department of Pediatric Surgery CSMMU, Lucknow, India

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Date of Web Publication14-Mar-2012

How to cite this article:
Singh S, Wakhlu A. Megaesophagus in the pediatric age group: A diagnostic dilemma. Saudi J Gastroenterol 2012;18:151-2

How to cite this URL:
Singh S, Wakhlu A. Megaesophagus in the pediatric age group: A diagnostic dilemma. Saudi J Gastroenterol [serial online] 2012 [cited 2022 Nov 29];18:151-2. Available from:

A 5-year-old boy weighing 8 kg presented with recurrent pulmonary infections, occasional nonbilious vomiting, intermittent cough, and failure to thrive since birth. On physical examination, vital signs were normal, but on auscultation left-sided fine crackles were found. The child was anemic, other blood biochemistry levels were within the normal range. A chest X-ray and computed tomography (CT) revealed bronchiectasis localized to the left hemithorax and a radiolucent air column within a distended esophagus. Other causes of chronic pulmonary diseases, such as cystic fibrosis, congenital immune deficiencies and primary ciliary dyskinesia were excluded. A barium swallow demonstrated a dilated esophagus with an air-fluid level and sudden narrowing at the distal end [Figure 1]. Esophageal manometry showed uncoordinated, low-amplitude peristalsis of the esophageal body and the lower sphincter pressure was normal.
Figure 1: A barium swallow showing pneumoesophagus and a dilated esophagus with a narrowed cardioesophageal junction

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   Question Top

Q1. What is the diagnosis?

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   References Top

1.Ng J, Bartram J, Antao B, Everard M, Shawis R. H-type tracheoesophageal fistula masquerading as achalasia cardia in a 13-year-old child. J Paediatr Child Health 2006;42:215-6.  Back to cited text no. 1
2.Olivet RT, Payne WS. Congenital H-type tracheoesophageal fistula complicated by achalasia in an adult: Report of a case. Mayo Clin Proc 1975;50:464-8.  Back to cited text no. 2
3.Stephens RW, Lingeman RE, Lawson LJ. Congenital tracheoesophageal fistulas in adults. Ann Otol Rhinol Laryngol 1976;85:613-7.  Back to cited text no. 3
4.LaSalle AJ, Andrassy RJ, Ver Steeg K, Ratner I. Congenital tracheoesophageal fistula without esophageal atresia. J Thorac Cardiovasc Surg 1979;78;583-8.  Back to cited text no. 4
5.Le SD, Lam WW, Tam PK, Cheng W, Chan FL. H-type tracheo-oesophageal fistula: Appearance on three-dimensional computed tomography and virtual bronchoscopy. Pediatr Surg Int 2001;17:642-3.   Back to cited text no. 5
6. Boybeyi O, Köse M, Ersöz DD, Haliloglu M, Karnak I, Senocak ME. Achalasia-like findings in a case with delayed diagnosis of H-type tracheoesophageal fistula. Pediatr Surg Int 2008;24:965-9.  Back to cited text no. 6

Correspondence Address:
Sunita Singh
Department of Pediatric Surgery, CSMMU, Lucknow
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-3767.93827

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This article has been cited by
1 Diagnostic and management strategies for congenital H-type tracheoesophageal fistula: a systematic review
Keerthika Sampat, Paul D. Losty
Pediatric Surgery International. 2021; 37(5): 539
[Pubmed] | [DOI]


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