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Clinical Problem Solving: Radiology
March 2007

Radiology Quiz Case 2: Diagnosis

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2007;133(3):300-301. doi:10.1001/archotol.133.3.300-b

Congenital high airway obstruction syndrome is a rare condition that is characterized by complete or near-complete obstruction of the upper airway in a fetus. Pathogenetic factors may include laryngeal atresia, laryngeal cysts, laryngeal or tracheal webs, and severe subglottic stenosis.1 The syndrome is diagnosed in utero by ultrasound, with common findings including large, echogenic lungs; a flattened or inverted diaphragm; ascites or hydrops; and dilated airways distal to the obstruction. The findings of prenatal ultrasonography are frequently suggestive of, but not diagnostic for, CHAOS. In such cases, the condition may then be confirmed with the use of ultrafast fetal MRI.2