11 / 16
Notes:
Page 23
Volume 5
Journal of Pediatric Care
ISSN: 2471-805X
JOINT EVENT
Neonatology 2019
Pediatrics Surgery 2019
April 23-24, 2019
April 23-24, 2019 London, UK
&
23
rd
Edition of International Conference on
Neonatology and Perinatology
4
th
International Conference on
Pediatrics and Pediatric Surgery
Oesophageal atresia with tracheoesophageal fistula: An unusual radiological presentation
Neaha Patel
Homerton University Hospital, UK
A
term male infant was admitted to the local neonatal unit at eighteen hours with respiratory distress and copious
white secretions. He was intubated and ventilated; on chest x-ray (CXR) the nasogastric tube (NGT) was seen
in the stomach and he was extubated shortly afterwards. Six hours after extubation, he developed respiratory distress
and was reintubated. The NGT was re-inserted but appeared coiled on repeat CXR, suggesting oesophageal atresia
(OA) with tracheo-oesophageal fistula (TOF). He was transferred to our neonatal unit and had an uncomplicated
surgical repair. Revisiting his initial CXR, the NGT can be seen parallel to the endotracheal tube, passing through
the TOF into the oesophagus where a kink is seen and onwards into the stomach. Post extubation, the oesophageal
pouch appears as a lucency extending from the neck into the upper mediastinum. In OA with distal TOF, an NGT
coiled in the oesophageal pouch on CXR is usually diagnostic. Rarely, however, the NGT may enter the stomach via
the trachea and fistula, as seen in this case. The key message is that neither an NGT in the stomach nor a positive pH
test excludes OA with distal TOF. In H-type fistulae, the NGT would also appear in the stomach. Careful review of
the CXR is advised to avoid delaying diagnosis; an NGT travelling alongside the endotracheal tube, or a kink in its
course, may act as indicator.
Biography
Neaha Patel has completed her Graduation from the University of Birmingham in 2013 and is currently an ST4 Pediatric Registrar working in the Neonatal
Intensive Care Unit at the Homerton University Hospital. She has a keen interest in neonatology and is pursuing her Postgraduate Diploma in Pediatric Infectious
Diseases at Oxford University, with a view to develop an interest in neonatal infection. She has published one work in a reputed journal.
neaha.patel@nhs.netNeaha Patel, J Pediatr Care 2019, Volume 5
DOI: 10.21767/2471-805X-C1-020