Esophageal Atresia With Distal Tracheo-Esophageal Fistula

Etiology: Congenital
Imaging CXR: Dilated proximal pouch with coiled nasogastric tube within it and distal intestinal gas
DDX:
Complications: At risk for having tracheomalacia due to compression from the dilated proximal esophageal pouch
Treatment: Surgical
Clinical: Most common (85%) esophageal atresia

Radiology Cases of Esophageal Atresia With Distal Tracheo-Esophageal Fistula

CXR of esophageal atresia with distal fistula — CXR shows a nasogastric tube coiled within a dilated proximal esophagus. There is gas in the stomach.

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.

CXR of esophageal atresia — CXR AP shows a nasogastric tube looped upon itself forming a figure 8 in the proximal esophagus. There is gas present in the stomach and bowel.

CXR of esophageal atresia — Initial CXR AP (left) shows an air-filled dilated proximal esophagus to the left of the endotracheal tube. CXR lateral (right) taken later after nasogastric tube was placed and could not be advanced further shows interval decompression of the proximal esophagus. There is gas present in the stomach and bowel.