X-ray
Describe the appearance of the upper mediastinum. What is the likely diagnosis?
There is a dilated upper oesophagus which is filled with gas. Features are consistent with oesophageal atresia.
What types of oesophageal atresia do you know? Which one is this (and why)?
There are 5 types, typed A to E. The commonest, type C, accounts for 85% of cases and represents oesophageal atresia with distal fistula. In this case, there is a blind ending upper pouch (A or C) and gas within the stomach and small bowel (C, D or E). Therefore, this most likely represents a type C fistula.
Coned view of the upper mediastinum.
The upper oesophagus is dilated and filled with gas. There is an abrupt transition between the dilated gas-filled upper oesophagus and the mid-oesophagus which is not visible.
As demonstrated on the complete film, the ET is above the carina and the UAC is in an aortic-arch-branch vessel.