An Unexpected Connection: Undetected H-type Tracheoesophageal Fistula in an Adolescent Male

H-type tracheoesophageal fistula is a rare congenital anomaly characterized by an abnormal connection between the oesophagus and trachea without oesophageal atresia. Typically diagnosed in infancy, its symptoms can range from intermittent coughing while swallowing liquids to recurrent lower respiratory infections. Surgical repair remains the definitive treatment, with open procedures being the conventional approach; however, thoracoscopic intervention has demonstrated efficacy in selected cases. This case highlights the need for heightened clinical suspicion and underscores the critical role of early bronchoscopy in diagnosing atypical or chronic respiratory presentations, potentially reducing diagnostic delays and improving patient outcomes.