Esophageal Atresia Without Tracheo-Esophageal Fistula Etiology: congenitalCXR: dilated proximal pouch with coiled nasogastric tube within it, no distal intestinal gasComplications: often have a long gap between esophageal segmentsClinical: second most common (10%) esophageal atresia Cases of Esophageal Atresia Without Tracheo-Esophageal Fistula AP image from a vintage upper GI shows contrast that had been injected into a dilated proximal esophageal pouch (left) that was subsequently aspirated into the trachea (right). AXR shows a gasless abdomen. Segmentation anomalies are noted in the sacrum suggesting the presence of VATER syndrome. CXR | AXR shows a nasogastric tube in the proximal esophagus and a massively distended abdomen. Transverse US image of the upper abdomen (below) shows a dilated duodenal bulb (left) and a dilated stomach (right), a double-bubble sign. CXR AP and Lateral shows a nasogastric tube that cannot be further advanced into the distal esophagus.