NB female child presented with c/o looking pale and noisy respiration after few hours of birth, o/e frothing present... NG tried but couldn't pass through both nostril ?choanal atresia, low set ears, passed meconium... on auscultation b/l create heard, S1 S2 audible... P/A soft.. immediately shifted to pedia surgical dept.. diag n possible syndromes..

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VACTERAL anomaly V - Vertebral anomaly - this child has Hemi vertebrae A - Ano rectal anomaly - check it C - Cardiac anomaly - ECHO ll clarify it TE - Tracheo oesophageal fistula. This child has that R - Renal anomaly - USG KUB ll clarify And Limb anomaly - here there s polydactyly
Child has tracheo oesophageal fistula Associated anomalies VACTERAL Vetebral Anorectal malformation Cardiac Tracheo esophageal fistula Renal Limb Place the child in prone head down position if u suspect tef. (Polyhudramnios antenetally, postnatally frothing from mouth, respiratory distress, inability to pass ng tube, coiling of ng tube in cxr) to prevent aspiration and ger Emergency surgery, refer to ped surgeon. Look for associated anomalies CHARGE association Coloboma Heart disease Atresia of choana Retardation Genital abnrmlty Ear abnrmlty
Frothing, Noicy Respirations, Baby looks Pale. N.G TUBE NOT PASSED BOTH NOSTRILS. DISCUSSION : WHEN THE BABY IS PALE, NO CYNOSIS WHEN THE BABY CRYING - DO NOT GOES IN FAVOUR OF CJOANAL ATRESIA. ON THE OTHER HAND FROATHING PER MOUTH GOES IN FAVOUR OF " TEF " RIGHT SIDE POLY-SYNDACTYLE PRESENT. SCAN FOR OTHER CONGENITAL ANOMALIES TOO. DX : TEF WITH POLY-SYNDACTYLE Rt. HAND.
Bit faded but NG is visible in CXR...
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TEF with VACTERAL anomaly
Tracheoesophagal fistula.... Radiograph favors it with polydactyly of rt.hand
Could be tef .may need immediate surgery
Yes definitely TEF is there along with other anomalies...
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I agree with Dr.R.Khan
VACTERAL Sequence
TO fistula.
Syndactly

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