A neonate has excessive frothy secretions and choking on the first feed. Repeated attempts to pass a nasogastric tube fail, and the chest X-ray shows the coiled tube lying in the upper mediastinum. Notably, there is complete absence of gas in the stomach and intestines. This radiographic pattern corresponds to which anomaly?

• A Esophageal atresia with distal tracheoesophageal fistula
• B Esophageal atresia with proximal fistula only
• C H-type tracheoesophageal fistula with intact esophagus
• D Isolated esophageal atresia without any tracheoesophageal fistula ✓

Explanation

Gasless abdomen in esophageal atresia means no communication exists between the tracheobronchial tree and the distal esophagus, so swallowed air cannot reach the gut. This occurs in pure esophageal atresia without fistula, which also carries the highest association with long-gap atresia. In the commonest variant, atresia with distal fistula, gas is present in the stomach and bowel. An H-type fistula has a patent esophagus, so the nasogastric tube would pass into the stomach.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.