Presentation
Inability to swallow milk, aspiration during feedings. Failure to pass orogastric tube to stomach.
Patient Data
Plain film shows orogastric tube not passing to the stomach, instead it is turning back superiorly.
After injection of non-ionic water soluble contrast material in the orogastric tube, there is no evidence of passage of contrast to the middle and distal esophagus. The proximal esophagus is dilatation.
Aspiration of contrast is noted from the level of epiglottis rather than proximal tracheo-esophageal fistula.
No distal gas is noted in the stomach, excluding the possibility of distal fistula.
Case Discussion
Isolated esophageal atresia (type A) occurs in approximately 8% of cases of esophageal atresia. In this entity there is no proximal or distal fistula with the trachea. The possibility of distal distal tracheo-esophageal fistula can be excluded when there is no distal gas in the gastrointestinal tract.
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