Prenatal findings of concomitant duodenal and esophageal atresia without tracheoesophageal fistula (Gross type A).

Prenatal diagnosis of concomitant duodenal atresia (DA) and esophageal atresia (EA) without tracheoesophageal fistula (TEF) (Gross type A) is very rare. We describe prenatal findings of one such case. Sonographic examination of a 26-week fetus showed a double cystic structure and an intrathoracic cyst. MRI and ultrasound at 26 weeks and 2 days' gestation showed shrinkage of the stomach and duodenum, massive ascites, and the presence of dilated pouch-like structure in the thoracic inlet level, consistent with an upper pouch sign. Polyhydramnios was detected at 30 weeks' gestation. Prenatal diagnosis was concomitant DA and an intrathoracic anomaly such as congenital hiatal hernia, diaphragmatic hernia, esophageal duplication or EA. A boy was delivered at 38 weeks' gestation. Physical examination showed a markedly distended abdomen and imperforate anus. Emergency surgery revealed existing DA and EA without TEF (Gross type A). (c) 2009 Wiley Periodicals, Inc.