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Dysmorphic patient presenting with:
- Multiple vertebral fusion abnormalities
- congenital heart disease (VSD)
- trache-oesphageal fistula with esophageal atresia
- plus rib fusion abnormalities and duodenal atresia.
The gas is thought to have passed into the distal bowel by bypassing the duodenal atresia via the accessory pancreatic duct and into the ampulla.
Chest and abdominal x-ray of a patient with VACTERL.