A male neonate delivered at 32 weeks of gestation presented with cyanosis and respiratory distress. His mother did not receive proper antenatal care. The neonatologists performed endotracheal intubation and tracheostomy, which were not successful. Bag-valve-mask ventilation was performed, however, the neonate succumbed to respiratory failure four hours after delivery. A barium esophagram obtained post mortem is shown in the cover image. Additional post mortem findings included dysmorphic facial features, a double superior vena cava, an ostium secundum atrial septal defect, and a horseshoe kidney.
Postnatal karyotyping revealed trisomy 18. What does this esophagram suggest? Stay tuned for the correct answer! *This image challenge is from the Editorial team of Docplexus and is meant for educational purposes only. Source – NEJM
