Abstract
The existence of an additional upper oesophagotracheal fistula in cases of oesophageal atresia may easily be overlooked. But it may give rise to serious danger for the child after operation. The problems of diagnosis are discussed in the light of experience with 5 cases and 1 case with an upper fistula only. Treatment recommended is closure of the lower fistula, anastomosis and removal of the upper fistula in the same stage. In all cases closure of the upper fistula was carried out through a cervical approach.