Chest
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A 43-year-old woman without significant medical history was admitted with fatigue for 2 months. Before her current presentation, she had experienced several weeks of heavy menstrual bleeding and easy bruising. ⋯ The patient admitted a 20-year half-pack per day smoking habit that she had not been able to quit. She denied significant occupational or environmental exposures, a family history of malignancy, or current use of medications.
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Congenital tracheoesophageal fistula is usually diagnosed at an early age, but may remain undetected into adulthood if atresia is absent and if the fistula is small. A tracheoesophageal fistula should be suspected in patients with unexplained episodes of respiratory distress or pneumonia; however, more subtle signs can be an important symptom for early recognition of the disease. ⋯ In the present case, air movement between the esophagus and the trachea through the fistula caused a high-pitched sound, which the patient described as a "catlike cry." The high-pitched sound ceased after surgical closure of the fistula. We report here the symptom of "catlike cry" as one manifestation of tracheoesophageal fistula.