A newborn male is noted to have difficulty feeding and "turns blue and chokes when drinking formula." The prenatal records reveal that the amniotic fluid appeared normal on ultrasound. A pediatric feeding tube is passed orally to 20 cm without difficulty, with gastric secretions aspirated. Which of the following is the most likely diagnosis

The vast majority newborns with TE fistulae involve a nonpatent esophagus that is diagnosed by the inability to pass a feeding tube. However, the baby in this case most likely has an unusual type of TE fistula (H type) in which the esophagus is patent but there is a connection between the esophagus and the trachea. When the baby feeds, the formula is aspirated into the tracheobronchial tree, leading to choking and cyanosis. This condition may be diagnosed with a radiologic contrast study and requires surgical correction. Ref:- Harsh mohan textbook of Pathology