Fluoroscopic Findings of Tracheoesophageal Fistula 

 

*Fistula line visualization: An abnormal communication between trachea and esophagus is seen, typically when contrast leaks into the trachea during swallowing.

 

*Contrast leakage: Definitive sign is contrast agent leaking from esophagus to trachea or vice versa.

 

*Coughing or aspiration: Patient may cough suddenly during swallowing, matching clinical signs to fluoroscopic findings.

 

*Abnormal air passage: Air bubbles entering the airway from esophagus are seen during contrast passage.

 

*Early contrast entry into lungs: Due to fistula, contrast can reach lungs or bronchi early, indicating aspiration risk.

 

*Location and size of fistula: Usually at lower cervical or upper thoracic level; exact site determined by contrast leak location.

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*Trick point: Patient positioning and swallowing technique are crucial; lateral view with soft and quick swallowing improves fistula detection.

 

*Trick point: For small fistulas with subtle leaks, slow and careful contrast administration is recommended.

 

*Additional findings: Esophageal dilation, motility disorders, or irregular tracheal wall may be seen.

 

*Limitations of fluoroscopy: Small or complex fistulas can be missed; complementary CT or endoscopy

may be necessary.