Esophageal intubation via a tracheoesophageal fistula - Type C

Tracheal intubation and ventilation in neonates with esophageal atresia and tracheoesophageal fistula can be challenging, and may lead to catastrophic results if mismanaged. We present a case of a 2.2 Kg, otherwise well, full term neonate was scheduled for a thorachoscopic repair of a type C tracheoesophageal fistula. During tracheal intubation the endotracheal tube migrated into the esophagus, not enabling ventilation. We present possible immediate solutions for this rare emergency are, and a more anatomically accurate schematic drawing of type C tracheoesophageal fistula, possibly making the possibility of esophageal intubation via a fistula, as well as the management strategies better understood.