Bronchoesophageal fistula in a neonate: radionuclide study as diagnostic modality

A neonate with H-type fistula between esophagus and right bronchus is described. He presented with an uncommon symptom of hypersialosis. The fistula was missed both at cinesophagogram and endoscopy, the modalities currently held as investigations of choice for the diagnosis of this entity. Instead it was incidentally picked up by radionuclide study undertaken to rule out dyskinesia or gross gastroesophageal reflux, which demonstrated the tract unequivocally. To the best of our knowledge this modality has not been used earlier for this purpose. The authors feel that although persistence in attempts to demonstrate the tract preoperatively is important, radionuclide study can also be considered as a diagnostic tool in difficult cases.