Esophageal Atresia (Differential Diagnosis RDS)

atno_22aEn_n.jpg: Types of esophageal malformations. In each single illustration, the trachea including the bifurcation is on the right side, the esophagus on the left. In 3b the upper esophagus ends blindly, and a connection runs from the trachea continuously into the esophagus. In 4 the continuity of the esophagus is preserved, but there is a connection between trachea and esophagus. atno_22b_n.jpg: Chest and abdomen x-ray of a newborn. The tube introduced into the esophagus cannot be advanced downwards and lies with the visible end in the upper mediastinum (at the level of the 4th thoracic vertebral body). In the abdominal part of the x-ray no air-containing structures are visible. Which type of esophageal atresia in atno_22aEn_n.jpg do these findings correspond to? atno_22c_n.jpg: The drawing shows some structural details of types 3b and 4 observed more frequently and described under atno_21a_n.jpg. Figure atno_22aEn_n.jpg to atno_22c_n.jpg: In esophageal atresia, food intake is not possible because of continual regurgitation. A secondary aspiration of saliva or tea or milk fed by mistake or of refluxing gastric juice leads to pneumonia and continuous respiratory distress syndrome. The esophageal atresia is an example of how in congenital malformations of the gastrointestinal tract or other causes of regurgitation, dysphagia and vomiting and in abdominal emergencies a respiratory distress syndrome or respiratory signs are in the forefront of clinical presentation if the primary cause is diagnosed with a delay. Of the different types of esophageal atresia, type 3b, 3c (if looked for), and 4 are observed most frequently. The findings of the chest and abdomen x-ray in atno_22b_n.jpg belong to the rare type 2 or 3a because there is no air in the gastrointestinal tract, making a distal tracheoesophageal fistula unlikely.