IN A newborn infant who presents with excessive salivation, choking spells, cyanosis, and coughing when fed, an esophageal atresia should be strongly suspected. The infant should be immediately evaluated by passing a stiff urethral catheter through the nares in an attempt to reach the stomach. If an esophageal atresia is present, the catheter tip will meet resistance after being inserted 10 to 13 cm. Occasionally, however, the catheter coils in a spacious upper pouch and allows more than 13 cm of tube to be inserted. In this instance the impression is that the catheter tip has passed into the stomach, and the suspicion of esophageal atresia may be mistakenly dismissed. The incorrect conclusion results from not knowing the position of the catheter tip once it has passed the nares.
The purpose of this report is to present a simple, clinical procedure which will assist the examiner by providing evidence as