Esophageal Atresia Without Tracheo-Esophageal Fistula

  • Etiology: Congenital
  • Imaging CXR: Dilated proximal pouch with coiled nasogastric tube within it, no distal intestinal gas
  • DDX:
  • Complications: Often have a long gap between esophageal segments
  • Treatment: Surgical
  • Clinical: Second most common (10%) esophageal atresia

Radiology 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.
CXR of esophageal atresia without tracheo-esophageal fistula
CXR AP (above left) shows the chest to be unremarkable aside from a right sided aortic arch. However, there is no air seen within the gastrointestinal tract. CXR lateral (above right) shows the proximal esophagus behind the trachea to be very dilated. CXR obtained after placement of a nasogastric tube (below) shows the nasogastric tube to be looped within the proximal esophagus.