Recurrent respiratory tract infections in children; beyond medical causes!

required ventilator support. A paediatric surgery referral was sent in view of history of repeated admissions for severe recurrent RTI every 3-4 weeks since birth. A flexible endoscopic examination revealed a fistulous opening in the posterior wall of the trachea raising the suspicion of an H type trachea-oesophageal (TEF) fistula. On deeper probing, the mother gave a history of choking during feeds. After proper stabilization rigid bronchoscope under general anaesthesia revealed a fistula in the posterior wall of trachea which was first cannulated, and then ligated and repaired from the right cervical route (Figure 1). The child was discharged after 10 days and was followedup for the next 10 months. He had no other episode of RTI which required admission.