Measurement of intragastric oxygen concentration for the diagnosis of H-type tracheoesophageal fistula.

The demonstration of an H-type tracheoesophageal fistula before surgical correction is frequently difficult. Currently utilized procedures are so irregularly successful that surgical exploration is sometimes necessary without prior demonstration of the fistula. A case is reported in which the diagnosis was made by measurement of intragastric oxygen concentration, which increased and declined in response to the endotracheal insuffation of 100% oxygen and room air, respectively. The fistula was subsequently demonstrated by barium esophagram and was successfully treated surgically. In the presence of the classic clinical triad (choking during feedings, abdominal distention, and pneumonitis), a positive intragastric oxygen test may be sufficient indication for surgical exploration.