A newborn has dribbling after feeds. He has respiratory distress and froths at the mouth. Diagnosis is –

Tracheoesophageal fistula and esophageal atresia Esophageal atresia is the most common congenital anomaly of the esophagus. More than 90% are associated with tracheoesophageal fistula. The most common variety is the one where the upper part of esophagus ends blindly and the lower part is connected to trachea by a fistula. TEF should be suspected in all cases of hydramnios. There may be associated anomalies → VACTERL (vertebral, anorectal, cardiac, tracheal, esophageal, renal, radial, limb) syndrome. Presentations Frothing and bubbling at the mouth and nose. Coughing, cyanosis and respiratory distress. Feeding exacerbates these symptoms, cause regurgitation, and may precipitate aspiration. Aspiration of gastric contents via distal fistula can cause aspiration pneumonitis.