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Case reports Case 1. A girl who had been investigated in two hospitals for recurrent attacks of chest infection and episodes of abdominal distension dating back to birth. Barium swallow examinations at 10 and 15 months were reported as normal. Finally, an oesophagogram, with the dye injected through a catheter placed in the oesophagus, showed tracheal spill through a fistula at the level of the second and third dorsal vertebrae. She was operated on when 21 years of age through a left supraclavicular approach. Uneventful recovery followed.Case 2. A 7-day-old female infant was admitted with a history of being 'mucousy' since birth. This was associated with abdominal distension. The child became cyanosed after admission and chest x-ray examination showed right upper zone pneumonitis.Barium swallow examination 8 days later did not show anything abnormal, but a repeat examination outlined a fistula. The fistula was divided through a left supraclavicular approach. The infant died 10 hours after the operation. Post-mortem examination showed extensive bronchopneumonia.Case 3. A female newborn infant was admitted with a history of respiratory distress, abdominal distension, and vomiting. The child developed right-sided pneumonitis within the first 7 days. Barium enema and Received 26 February 1975. meal examinations were normal apart from revealing uncomplicated malrotation. Gastrografin swallow examination at one month of age showed evidence of a vascular ring. At 37 days of age an aberrant right subclavian artery was divided through a left thoracotomy. The child failed to improve after this and weighed only 6* 12 kg when 10 months old. A repeat oesophagogram then revealed a fistula. Division of this through a left cervical approach was followed by uneventful recovery.Case 4. A female infant was admitted when 2 months old with a history that she became distressed after every feed with vomiting, cyanosis, and dyspnoea and also had episodes of abdominal distension. Chest x-rays showed patchy pneumonitis on the right side. An oesophagogram showed an H-fistula at the level of the first thoracic vertebra. The child was operated upon at 10 weeks of age through a left cervical approach and made an uneventful recovery.Case 5. A male infant was detained in a neonatal unit for 5 weeks after birth because of a chest infection, and was readmitted when 3 months old for a recurrence of the same complaint. When he was admitted to our hospital at 9 months of age for a chest infection an oesophagogram showed an H-type fistula. This was divided through a left supraclavicular approach. Postoperative recovery was uneventful.

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A 63-year-old diabetic gentleman with proprioceptive-induced seizures is reported. Marked hyperglycemia due to discontinuation of anti-diabetic medication was the precipitating cause. Distinctive clinical feature of this case was recurrent focal motor seizures involving the left upper limb precipitated by volitional movements of the same limb and self-aborted by holding the affected limb with the contralateral limb. This was accompanied by left brachial weakness without corresponding lesions on cranial MRI. Despite rapid achievement of euglycemia, seizures persisted and required anticonvulsant polytherapy for effective control.

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