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August 1988

Radiological Case of the Month

Author Affiliations

Contributed from the Departments of Radiology (Drs Mandell and Bowen) and Pediatrics (Dr Shaw), Children's Hospital of Pittsburgh and University of Pittsburgh School of Medicine. Dr Mandell is now with St Francis Medical Center, Pittsburgh.

Am J Dis Child. 1988;142(8):891-892. doi:10.1001/archpedi.1988.02150080097033

A 1340-g male infant, the product of 32 weeks' gestation and spontaneous vaginal delivery, had Apgar scores of 0 and 3 at one and five minutes, respectively. The infant was intubated and resuscitated, but respiratory distress persisted. He was transferred to Magee-Womens Hospital in Pittsburgh at 2 days of age. On physical examination, the abdomen was soft, but some examiners questioned the presence of a fluid-filled mass in the left lower quadrant. Roentgenograms of the chest (Fig 1) and abdomen (Fig 2) and an abdominal ultrasonogram (Fig 3) were obtained.

Denouement and Discussion 

Coexisting Duodenal and Esophageal Atresia Without Tracheoesophageal Fistula  It was not possible to pass a nasogastric tube into this infant's stomach. At the outlying hospital, a roentgenogram with barium suspension injected into the proximal esophagus had confirmed esophageal atresia. Chest roentgenogram showed hyaline membrane disease, the caudal tip ofthe nasogastric

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