Presentation
Difficulty in inserting feeding tube. History of polyhydramnios on antenatal scan.
Patient Data
A coiled feeding tube is noted in the upper esophagus. Lungs are well aerated and clear. Gas is seen in the stomach and proximal small bowel loops.
Umbilical catheters are seen in place; tip of umbilical venous catheter (UVC) is seen in the right hypochondrium and tip of umbilical arterial catheter (UAC) is seen at T7/T8 level.
1st and 4th thoracic butterfly vertebra.
Single viable intrauterine fetus with transverse lie. Average gestational age is 36 weeks 2 days. Fetal heart rate is 137 bpm. EFW is 2672 g. Turbid amniotic fluid with increased volume; amniotic fluid index (AFI) measures 40.29 cm. Anterior placenta. Normal doppler ultrasound of the umbilical and middle cerebral arteries. No gross fetal anomaly seen.
Case Discussion
The baby was delivered through an emergency C-section due to maternal complaint of decreased fetal movements for two days and finding of transverse lie on the obstetrical ultrasound. The baby was operated next day after the delivery and the intraoperative findings confirmed the presence of proximal esophageal atresia with distal tracheo-esophageal fistula (the commonest type).
The baby had no other gastrointestinal, renal, cardiac or musculoskeletal abnormalities.
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