A rare pitfall in the diagnosis of oesophageal atresia.

The diagnosis of oesophageal atresia (OA) is usually made soon after birth. Two diagnostic criteria are failure to pass a nasogastric (NG) tube and a chest radiograph demonstrating a curled NG tube in the upper oesophageal pouch. A 6-day-old neonate was referred to our institution with persistence of symptoms following exclusion of the diagnosis of OA on the basis of an NG tube radiologically confirmed to reach the stomach. Persistent oxygen desaturations and copious salivation led to further investigations, and a delayed diagnosis of oesophageal atresia and tracheo-oesophageal fistula was made. Radiological demonstration of an NG tube reaching the stomach does not exclude the diagnosis of oesophageal atresia and can be falsely reassuring and lead to diagnostic delay.