Which one of the following life-threatening congenital anomalies in the newborn presents with polyhydramnios, aspiration pneumonia, excessive salivation and difficulty in passing a nasogastric tube?
c. Tracheo-esophageal fistula(Ref: Nelson's 20/e p 1783, Ghai 8/e p 176)Presence of polyhydramnios, aspiration pneumonia, excessive salivation and difficulty in passing a nasogastric tube all point towards a diagnosis of tracheoesophageal fistula, which is usually accompanied by esophageal atresia.Esophageal atresia (EA) and TEF (Tracheoesophageal fistula):Important features* EA is the most frequent congenital anomaly of esophagus; 90% of EA babies have TEF* Most common type is upper esophagus ends in a blind pouch and TEF connected to distal esophagusTypical presentation* Maternal polyhydramnios is seen; New born presents with respiratory distress and excess oral frothing;* Newborn regurgitates all of its feeds; Saliva pours almost continuously from the mouth of the infant* Attacks of coughing and cyanosis occurs on feeding; Feeding tube cannot be passed more than 10cmDiagnosis* Chest X-ray with a red rubber catheter passed per orally shows coiled rubber catheter in a lucent proximal esophageal pouch* X-ray abdomen; Gas in the stomach is seen if there is communication between the lower part of the esophagus and trachea, which occurs in the commonest variety of tracheoesophageal fistula
Gastroschisis
Diaphragmatic hernia
Tracheo-esophageal fistula
Choanal atresia
Gastro Intestinal System