Persistent esophagotrachea in a premature with progressive desaturation and prenatal US diagnosis of esophageal atresia. (a) Chest radiograph on 4 days of life demonstrates infiltrations in both lung fields and a tubular-shaped hyperlucency over the cervical and upper thoracic vertebrae. Note segmentation anomaly of the lower thoracic vertebrae. (b) Esophagogram shows a common lumen with both nasogastric and endotracheal tubes inserted. Note bronchial bifurcation from the distal one-third of a common lumen, which is distally continued to the esophagus

Congenital esophageal stenosis in a 6-month-old girl with history of surgical repair of esophageal atresia. Frontal view of the esophagram demonstrates focal concentric narrowing (arrow) of the distal third of the esophagus. Note residual deformity at the proximal esophagus indicating the site of the anastomosis

Congenital esophageal stenosis in a 20-month-old girl with sudden onset of choking. (a) Oblique view of the esophagram demonstrates an ovoid radiolucent filling defect impacted in the distal third of the esophagus and small barium projection (arrow) along the right lateral border of the filling defect. (b) Esophagogram after endoscopic removal of a bean shows focal narrowing at the distal esophagus and clearer demonstration of barium-filled diverticulum-like structure, representing characteristic of cartilaginous tracheobronchial remnants

Organoaxial volvulus in a 12-day-old neonate with hiatal hernia. (a) Plain radiograph shows air-filled structure with an unusual configuration in the retrocardiac and right paravertebral areas. (b) Image from UGI study demonstrates partial herniation of the stomach with inferiorly pointed pylorus. The greater curvature lies to the right of and superior to the lesser curvature

Mesenteroaxial volvulus in a 11-month-old girl with abdominal distension and vomiting. Supine (a) and erect (b) abdominal radiographs show a marked spherical distension of the stomach with two air-fluid levels. Note sternal wirings by previous surgery for congenital heart disease. (c) Image from UGI study after gastric decompression shows the antrum and pylorus lying above the fundus with upside-down stomach and pyloric obstruction with beaking. The lesser and greater curvatures maintain their normal relationship. Asplenia was confirmed at surgery

Duodenal atresia in a 1-day-old premature presented with vomiting. Abdominal radiograph demonstrates a markedly distended stomach and duodenal bulb giving the classic double bubble sign. Note lack of gas in the rest of the intestinal tracts

Duodenal stenosis by web in a 4-day-old neonate with bilious vomiting. (a) Abdominal radiograph shows gaseous distension of the duodenum and nondilated scattered gas-filled bowel loops distally. (b) Transverse abdominal US shows the fluid-filled, distended duodenum with a central teat configuration in the obstructed end (arrow). (c) Images from UGI study show the barium passage halting at the third portion of the duodenum, the bolus ending with a central teat configuration (arrow), similar to US finding. (d) Delayed image demonstrates a smooth transverse filling defect crossing the duodenal lumen and passage of barium beyond the lesion. The duodenal web with a pinpoint hole was found at surgery

Midgut volvulus with Ladd band in a 1-month-old boy presenting with bilious vomiting. (a) Abdominal radiograph demonstrates the distended stomach and paucity of gas in the remainder of the bowel loops. (b) Transverse US of the upper abdomen shows a whirl-like mass (arrows) in the upper abdomen in front of the vena cava (V) and aorta (A). (c) Corresponding color Doppler study shows a clockwise whirlpool sign with complete wrapping of the superior mesenteric vein, mesentery, and bowel loops around the superior mesenteric artery