Newborn with difficulty handling secretions who subsequently developed tracheomalacia

CXR AP (left) shows a nasogastric tube that cannot be advanced further in the esophagus. Vintage upper GI lateral image (right) shows a dilated proximal esophageal pouch compressing the airway. In current practice, there is no indication for doing an upper GI with positive contrast material.

The diagnosis was esophageal atresia with distal tracheo-esophageal fistula.