Esophageal atresia and tracheoesophageal fistula

Case history

A newborn presents at birth with mild respiratory distress and increased oral secretions. An attempt to pass a suction catheter meets with resistance. An attempt to pass a replogle tube also meets with resistance.

Other presentations

Up to 37% of patients are now diagnosed prenatally.[2]Pedersen RN, Calzolari E, Husby S, et al. Oesophageal atresia: prevalence, prenatal diagnosis and associated anomalies in 23 European regions. Arch Dis Child. 2012 Mar;97(3):227-32. http://www.ncbi.nlm.nih.gov/pubmed/22247246?tool=bestpractice.com Fetal ultrasound shows polyhydramnios and often no stomach bubble.

If the infant presents with a pure atresia (no fistula), the initial findings at delivery are similar. The nasogastric tube coils in the upper esophageal pouch; however, there is no air in the bowel as there is no connection to the airway. Associated anomalies may be present, such as cardiac, renal, limb, and spinal abnormalities.