Detection of tracheoesophageal fistula caused by ingestion of a caustic substance by esophageal scintigraphy.

A 4-year-old boy was referred for scintigraphic evaluation of esophageal transit 24 hours after he had ingested sodium hydroxide. After oral administration of Tc-99m sulfur colloid, scintigraphy showed marked and prolonged retention of the radioactive bolus in the middle and lower thirds of the esophagus. Three weeks after ingestion of the caustic substance, repeat scintigraphy was requested to evaluate esophageal transit and gastric-emptying. In this presentation, a tracheoesophageal fistula was a consequence of sodium hydroxide ingestion and was identified with radionuclide scintigraphy before there was clinical and radiologic detection.