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Comment: Congenital H-type fistula: delayed diagnosis in a preterm infant

ration pneumonia. At a postnatal age of 44 days, the patient weighed 1680 g and she was growing and sucking well in the hospital. She had started oral feeding by this stage; however, there were associated problems with choking, cyanosis and coughing, and she again developed right upper lobe pneumonia. At this point, a barium contrast rapidsequence cine-esophagogram was ordered. A nasogastric tube was inserted to the distal extent of the esophagus, and diluted barium was passed. The films revealed a fistula artifact at the level of T2–3 and contrast entering the trachea (Figure 1). After the problem was identified, surgery was performed through a right lateral cervical incision and the fistula was closed. There were no postoperative complications of recurrent fistula or laryngeal nerve damage.