Aspiration pneumonia due to tracheoesophageal fistula

Case contributed by Mohammad Ashkan Moslehi
Diagnosis almost certain

Presentation

3 mo/o infant with several episode of coughing and cyanosis from 2 week after birth time.

Patient Data

Age: 3 mo/o
Gender: Male

There are evidence of posterior segments alveolar infiltration in both lung fields with collapse of apical segment of LLL. Mosaic attenuation value in both lung fields with hyperaeration due to distal airways diseases are seen.
There is no evidence of anterior, middle and posterior mediastinal mass. Thymic atrophy is noticed. Major vessels are normal. Hilar regions are normal. Trachea and major bronchi have normal caliber.
No pathologic enhancement after IV contrast is seen.
There is no evidence of pathology in bony thorax and soft tissue thoracic wall.
Pleural effusion or thickening is not seen.

Case Discussion

He had positive history of couhing and chocking episode after oral feeding from when he was at 15 days old.

At admission time he had sever respiratory failure and stablization in PICU setup bronchoscopy (and dye injection in his esophagos) was done and tracheoesophageal fistula was confirmed in 1/3 middel part of trachea. 

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