A new born who has frothing of mouth. Cyanosis is present on day one. The most probable diagnosis is:

Ans. d. Esophageal atresia (Ref: Ghai 7/e p151: Nelson 19/e p1262)A new born who has frothing of mouth. Cyanosis is present on day one. The most probable diagnosis is esophageal atresia.'The diagnosis of esophageal atresia is entertained in an infant with excessive salivation along with coughing or choking during the first oral feeding.'Esophageal atresia:The diagnosis of esophageal atresia is e.ntertained in an infant with excessive salivation along with coughing or choking during the first oral feeding.Lung hypoplasia:The history may include poor fetal movement or amniotic fluid leakage and oligohydramnios.The neonate may be asymptomatic or may present with severe respiratory distress or apnea that requires extensive ventilatory support.In older children, dyspnea and cyanosis maybe present upon exertion, or a history of repeated respiratory infections maybe noted.Lung cyst:Found most often in young adults and are rare in infancy.The usual symptoms are the result of compression by the cyst, e.g., dyspnoea, dysphagia, cough and chest pain.Diaphragmatic hernia:Classic triad: Respiratory distress + Dextrocardia + Scaphoid abdomenQThe MC presentation is respiratory distress due to severe hypoxemia.The infant appears dyspneic, tachypneic, and cyanotic, with severe retractions.The anteroposterior diameter of the chest maybe large and the abdomen may be scaphoidQ.