<prompt> A new born baby had normal APGAR score at bih and developed excessive frothing and choking on attempted feeds. The investigation of choice is ?EsophagoscopyBronchoscopyMRI chestX-ray chest and abdomen with the red rubber catheter passed per orally into esophagus  <response>: Ans. is d i.e., X-ray chest and abdomen with the red rubber catheter passed per orally into esophagus o This is a case of tracheo esophageal fistula. CF of tracheo esophageal fistula a The newborn regurgitates all of its first and subsequent feeds. b Saliva pours almost continuously from the mouth of the infant This is the sign of tracheoesophageal atresia. It does not occur in any other condition c Attacks of coughing and cyanosis occurs on feeding. Clinical confirmation of diagnoses q If a nasogastric tube is tried to pass into the infant it will come against an obstruction within 10 cm. If this occurs the diagnosis is viually ceain. o Radiological confirmation of diagnosis a A lateral chest X-ray -- It shows a lucent proximal pouch that may displace trachea anteriorly. b X-ray abdomen -- Gas in the stomach is seen if there is communication between the lower pa of the esophagus and trachea which occurs in the commonest variety of tracheo-esophageal fistula. 