Severe stridor following the repair of H-type tracheoesophageal fistula in an 11 month infant.

Congenital tracheoesophageal fistula without esophageal atresia is commonly known as "H" type and this presents with a different clinical spectrum owing to the presence of a large and patent esophagus. There may be a time lag extending up-to 50 years between first presentation and confirmation of the diagnosis owing to the rarity of the condition, its nonspecific symptomatology, and limitations in its demonstration by contrast radiology and endoscopy. Respiratory sequelae are common following repair and may persist during the rest of life. We present here, the case of an 11 month old child who presented for a definitive repair of H-type tracheoesophageal fistula, diagnosed at the age of 9 months. Following an uneventful intraoperative course the child developed severe stridor in the postanesthesia care unit (PACU) 30 min after arrival necessitating endotracheal intubation. The further course of the child in the hospital, probable reasons for this unusual complication and its management are discussed.