Clinical Presentation

Difficulty passing an orogastric tube in a neonate.

Further Work-up

(A) Frontal chest radiograph demonstrates an esophageal tube with its tip in a proximal esophageal pouch (arrow), suggesting an esophageal atresia. The finding of gas in the stomach and bowel indicates an associated tracheoesophageal fistula. Cardiomegaly suggests congenital heart disease. (B) Longitudinal renal sonogram demonstrates multiple large renal cysts (arrows) that connect with the renal pelvis, consistent with severe hydronephrosis.