PMC7300232_01
PMC7300232_02
PMC7300232_03
Plain chest x-ray taken on the 16th day of life shows rigid tube with tip at T8 vertebra. Part of the tube is bent with irregular orientation inside the wide esophagus. Repeat x-ray on the same day also shows coiling of the tube around the same level.
gr1.jpg
PMC7300232_03_gr1.jpg
fig0005
T8 level. There was also consolidation of the right upper lobe and gas in the stomach (Fig. 1).
Esophagogram taken on the 20th day of life (AP and lateral views) demonstrate dilated esophagus tapering abruptly at T8 level.
gr2.jpg
PMC7300232_03_gr2.jpg
fig0010
Thereafter a barium swallow study was obtained which demonstrated a long dilated upper esophageal pouch reaching the lower chest (Fig. 2).
PMC7300232_04
Intraoperative image taken without any mobilization of the esophageal ends. The upper esophageal pouch (black arrow) was found dilated with thick wall and overlapping the lower esophagus (white arrow). The upper esophagus was held with vicryl stay suture to elevate it off the distal esophagus which was identified and held with a loop.
gr3.jpg
PMC7300232_04_gr3.jpg
fig0015
We found the upper esophageal pouch redundant, overlapping the distal fistula (Fig. 3).
PMC7300232_05