Tracheoesophageal fistula, esophageal atresia, and diaphragmatic hernia are surgical problems that may be recognized through neonatal clinical findings and imaging.
Tracheoesophageal fistula and esophageal atresia
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Excessive frothing in a neonate may indicate a tracheoesophageal fistula (TEF).
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Plain X-ray with a red rubber catheter inserted into the esophagus is used for confirmation; in esophageal atresia, the catheter stops at the 10th thoracic vertebra.
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A gastric bubble suggests a concomitant TEF.
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Avoid an infant feeding tube for this assessment because it may coil in the esophagus.
Diaphragmatic hernia
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Respiratory distress accompanied by a scaphoid abdomen suggests diaphragmatic hernia.
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Antenatal ultrasound can establish the diagnosis. Chest X-ray shows bowel loops within the thoracic cavity.