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Oesophageal atresia and tracheo-oesophageal fistula — MRCPCH TAS MCQ

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ModerateEmbryologyOesophageal atresia and tracheo-oesophageal fistulaMRCPCH TAS

A newborn has choking during first feeds, excessive salivation and inability to pass a nasogastric tube. Antenatal scans showed polyhydramnios. What is the most likely embryological mechanism?

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Correct answer: A — Abnormal partitioning of foregut into trachea and oesophagus

Oesophageal atresia with tracheo-oesophageal fistula results from abnormal foregut partitioning. Failure of midgut rotation causes malrotation and volvulus, not inability to pass a nasogastric tube. The pearl is that polyhydramnios reflects impaired fetal swallowing.

Reference: Gray's Anatomy; Nelson Textbook of Pediatrics; RCPCH Theory examination syllabi