Abdominal and GI imaging: oesophageal atresia: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Radiology · Abdominal and GI imaging: oesophageal atresia

Sample item

A newborn has frothing at the mouth and chokes on the first feed. A radiograph shows a nasogastric tube coiled in the upper chest and gas in the stomach and bowel. What is the most likely diagnosis?

AOesophageal atresia with a distal tracheo-oesophageal fistulaBH-type tracheo-oesophageal fistulaCIsolated oesophageal atresia without a fistulaDCongenital diaphragmatic hernia

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Oesophageal atresia with a distal tracheo-oesophageal fistula

A tube arrested in the upper pouch shows atresia, and gas below the diaphragm means air passes from the airway through a distal fistula into the stomach. This is the commonest variant, and a gasless abdomen would indicate no fistula.

Option by option

A. Oesophageal atresia with a distal tracheo-oesophageal fistula (correct)
Correct. A coiled tube with a gas-filled gut is the classic finding of the common type.
B. H-type tracheo-oesophageal fistula
An H-type fistula does not obstruct the oesophagus, so the tube passes into the stomach.
C. Isolated oesophageal atresia without a fistula
Without a fistula, the abdomen is gasless because no air can pass to the stomach.
D. Congenital diaphragmatic hernia
A diaphragmatic hernia shows bowel loops in the chest and a scaphoid abdomen, not a coiled tube.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Oesophageal atresia with a distal tracheo-oesophageal fistula. A tube arrested in the upper pouch shows atresia, and gas below the diaphragm means air passes from the airway through a distal fistula into the stomach.

Why is "H-type tracheo-oesophageal fistula" not the answer?

An H-type fistula does not obstruct the oesophagus, so the tube passes into the stomach.

Why is "Isolated oesophageal atresia without a fistula" not the answer?

Without a fistula, the abdomen is gasless because no air can pass to the stomach.

Why is "Congenital diaphragmatic hernia" not the answer?

A diaphragmatic hernia shows bowel loops in the chest and a scaphoid abdomen, not a coiled tube.

What concept does this question test?

It tests Abdominal and GI imaging: oesophageal atresia in Radiology. This is the commonest variant, and a gasless abdomen would indicate no fistula.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Abdominal and GI imaging: oesophageal atresia?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.