title: A gasless abdomen does not exclude distal tracheoesophageal fistula: the value of a repeat x-ray.
abstract: A "gasless abdomen" in babies with esophageal atresia (EA) has traditionally been thought to imply absence of a distal tracheoesophageal fistula (TEF). We present 3 neonates with a provisional diagnosis of EA, who had a gasless abdomen on an initial x-ray taken within the first 4 hours of life. These children were subsequently shown to have gas in the stomach associated with a distal TEF. Two children were examined on subsequent repeat x-ray of the abdomen, when gas was demonstrated in the stomach. Another child had a laparotomy for a gastrostomy when a distended stomach was found. This baby went on to have a thoracotomy and a routine repair of the distal TEF and an esophageal anastamosis. Based on our data of 65 cases of EA and distal TEF, it is recommended that an x-ray of the abdomen is repeated before surgery is undertaken if the gasless abdomen is documented during the first 4 hours of life.
authors.affiliation: Department of Paediatric Surgery, Bristol Royal Hospital for Children, BS2 8BJ Bristol, UK.
authors.forename: Malenka M
authors.initials: MM
authors.lastname: Gedicke
authors.forename: Milan
authors.initials: M
authors.lastname: Gopal
authors.forename: Richard
authors.initials: R
authors.lastname: Spicer
mesh_terms: D015897:Comorbidity; D004933:Esophageal Atresia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors; D014138:Tracheoesophageal Fistula / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery