PMC4013468_01
Chest radiograph on admission showing right-sided changes.
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F1
A chest radiograph (Figure 1) showed diffuse and homogenous airspace opacity in the right upper and middle zones with prominent perihilar markings.
Repeat chest radiograph 1 day after admission demonstrating resolution of the changes within 24 h.
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F2
The right-sided chest opacity had cleared by the following day (Figure 2) perhaps reflecting resolution of mucus plugging.
Post-aspiration chest x-ray showing well-defined radio-dense opacities through all zones of the right lung and similar but less extensive changes on the right.
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F3
A barium esophagram using a 50% dilution of 125 w/v barium for suspected gastro-esophageal reflux was performed via the nasogastric tube with the infant in the supine position and showed prompt reflux back to the cervical esophagus with significant aspiration of the contrast into the trachea and the lungs bilaterally (Figure 3).
Tracheoesophageal cleft with nasojejunal tube visible in the esophagus. Note the absence of a "fistula" or "tube connection" but a confluence of the tracheal and esophageal lumens.
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F4
At bronchoscopy, a large tracheo-esophageal cleft approximately 3.8 mm in diameter was seen on the posterior wall of the trachea 4 cm above the carina with the nasojejunal tube in the esophagus clearly visible through the cleft (Figure 4).