Plain film shows orogastric tube not passing to the stomach, instead it is turning back superiorly.
After injection of non-ionic water soluble contrast material in the orogastric tube, there is no evidence of passage of contrast to the middle and distal esophagus. The proximal esophagus is dilatation.
Aspiration of contrast is noted from the level of epiglottis rather than proximal tracheo-esophageal fistula.
No distal gas is noted in the stomach, excluding the possibility of distal fistula.