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Case report
An interesting case of ‘strange lines’ a neonate with oesophageal atresia, tracheo-oesophageal fistula, situs inversus abdominalis and azygos continuation
  1. Camille Legat1,
  2. Maissa Rayyan1,
  3. Herbert Decaluwe2 and
  4. Katherine Carkeek1
  1. 1Neonatal Intensive Care Unit, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
  2. 2Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium, Leuven, Belgium
  1. Correspondence to Dr Camille Legat; camille.legat{at}; Dr Katherine Carkeek; kate.carkeek{at}


We describe the case of a term baby boy born via vaginal delivery at 39 weeks gestation with oesophageal atresia, tracheaoesophageal fistula, situs inversus abdominalis and azygos continuation. The azygos continuation was diagnosed after cardiac echo and confirmed on cardiac catherisation after an unexpected umbilical line position on thoracoabdominal X-ray. The baby underwent a right-sided thoracotomy on day 1 of life for repair of the oesophageal atresia. A double fistula, of both the proximal and distal segments, of the oesophagus with short segment stenosis was confirmed. The tracheo-oesophageal fistulae were ligated and divided and the oesophageal atresia repaired by primary anastomosis without complications. The azygos vein was not ligated.

  • gastrointestinal surgery
  • paediatric surgery
  • neonatal and paediatric intensive care
  • cardiothoracic surgery
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  • Contributors CL and KC managed the admission and care of the patient in the neonatal intensive care unit of the University Hospital Leuven. CL and KC wrote the article, with reviews by MR and HD. MR supervised the neonatal management of the patient and now follows up the patient. She reviewed the article. HD supervised the surgical management of the patient. He reviewed the article. We thank Professor Marc Gewillig, head of pediatric cardiology, for his team’s involvement in assisting with echocardiography of the patient.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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