The prodromal symptoms of esophageal fistula are often not systemic, just neck discomfort, swelling and pain, combined with discomfort in swallowing; local swelling than the normal side, with pressure pain, but usually the swelling and pressure pain after surgery feels normal, it is difficult to draw our attention to the more characteristic signs is the local skin is dark red, the mass progressive enlargement. Differential diagnosis: 1, tracheoesophageal dendritic swelling: esophageal syphilis disease patients once the dendritic swelling leads to tracheal (bronchial) esophageal fistula is every choking and coughing when eating. In addition, other symptoms of esophagitis and obstruction may also occur. 2. Symmetrical expansion of the esophagus: The x-ray features of the lower esophageal web are different from both the middle esophageal web and the lower esophageal ring, with the proximal end of the web (cephalic end) showing symmetrical expansion of the esophagus and the distal end (esophageal vestibular area) showing a double concave surface. This is one of the clinical manifestations of oesophageal webbing and oesophageal rings. The oesophageal web and esophageal ring are easily confused with esophageal muscle contraction and stricture. Strictly speaking, oesophageal web is a thin (2-3 mm) and brittle web-like septum consisting of only the mucosa and submucosa in the lumen of the esophagus, which can be seen anywhere in the esophagus. The esophageal ring often refers to a thick, tough, narrow ring composed of the mucosal and muscular layers of the esophagus. It is difficult to distinguish between the two on X-ray, so the distinction between esophageal webs and rings should be based on symptoms, signs, X-ray signs esophageal manometry and endoscopic biopsy. Once the diagnosis is clear, a rapid evaluation of the patient’s condition, ventilation, nutritional status, and state of water-electrolyte disturbance should be given immediately, and then drainage and remedial surgery should be performed without hesitation.