What is Which one of the following life-threatening congenital anomalies in the newborn presents with polyhydramnios, aspiration pneumonia, excessive salivation and difficulty in passing a nasogastric tube? and explain in detail?
c. Tracheo-esophageal fistula(Ref: Nelson's 20/e p 1783, Ghai 8/e p 176)Presence of polyhydramnios, aspiration pneumonia, excessive salivation and difficulty in passing a nasogastric tube all point towards a diagnosis of tracheoesophageal fistula, which is usually accompanied by esophageal atresia.Esophageal atresia (EA) and TEF (Tracheoesophageal fistula):Important features* EA is the most frequent congenital anomaly of esophagus; 90% of EA babies have TEF* Most common type is upper esophagus ends in a blind pouch and TEF connected to distal esophagusTypical presentation* Maternal polyhydramnios is seen; New born presents with respiratory distress and excess oral frothing;* Newborn regurgitates all of its feeds; Saliva pours almost continuously from the mouth of the infant* Attacks of coughing and cyanosis occurs on feeding; Feeding tube cannot be passed more than 10cmDiagnosis* Chest X-ray with a red rubber catheter passed per orally shows coiled rubber catheter in a lucent proximal esophageal pouch* X-ray abdomen; Gas in the stomach is seen if there is communication between the lower part of the esophagus and trachea, which occurs in the commonest variety of tracheoesophageal fistula