Diagnostic roles of methylene blue test observed by bronchoscopy in congenital tracheoesophageal fistulas in children

doi:10.19538/j.ek2017030613

Abstract：Objective To assess retrospectively the diagnostic roles of methylene blue test observed by bronchoscopy in congenital tracheoesophageal fistulas (TEFs) in children.Methods We collected the clinical data of 5 patients,two of whom were diagnosed with congenital H-TEF and three of whom were diagnosed with recurrent TEF (rTEF) over the past 8 months in Shenzhen Children's Hospital.We respectively analysed and compared the results of contrast esophagography,regular bronchoscopy,methylene blue test observed by bronchoscopy and chest MDCT,all of which were performed on the above 5 patients.Results Each of these five cases was observed by bronschoscopy that methylene blue came out from the fistula of the trachea when methylene blue was injected into esophagus.Although all cases were examined by regular bronchoscopy,two recurrent TEFs cases weren't found the fistulas.Four cases were examined by contrast esophagography,but only one rTEF case was diagnosed.None of these 4 cases could be diagnosed by the results of chest MDCT,but air trapping in the lower esophagus could be seen in chest MDCT in these cases.Conclusion Methylene blue test observed by bronchoscopy is reliable in the diagnosis of congenital TEFs in children,which is the first recommendation.Both of esophagography and regular bronchoscopy can miss the diagnosis in congenital TEFs in children.The diagnostic value of MDCT is limited for this disease,but air trapping in the lower esophagus in MDCT implicates the possibility of congenital TEFs.