A newborn infant is diagnosed with oesophageal Artesia. Which assessment finding supports this diagnosis?

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This question was previously asked in

SGPGI Staff Nurse Official Paper (Held On: 28 Feb, 2024 Shift 1)

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Answer 1

Correct Answer: Continuous drooling

Rationale:

Oesophageal atresia (EA) is a congenital condition where the oesophagus, the tube that carries food from the mouth to the stomach, does not develop properly. Instead of forming a continuous passage, the oesophagus ends in a blind pouch or is abnormally connected to the trachea. This defect prevents the normal passage of food and saliva.
Continuous drooling is a hallmark sign of oesophageal atresia in newborns. Since the oesophagus is not properly connected to the stomach, any saliva produced by the infant cannot be swallowed and instead accumulates, leading to excessive and continuous drooling.
In addition to drooling, newborns with oesophageal atresia may experience choking, coughing, or cyanosis (bluish discoloration of the skin) during feeding due to the inability to properly swallow or the misdirection of food into the airway.

Explanation of Other Options:

Slowed reflexes

Rationale: While slowed reflexes may indicate neurological or developmental concerns, they are not specific to oesophageal atresia. Oesophageal atresia is primarily a structural defect of the oesophagus and does not directly impact reflexes.

Diaphragmatic breathing

Rationale: Diaphragmatic breathing refers to breathing that primarily uses the diaphragm, which is normal for newborns. This is not indicative of oesophageal atresia. However, respiratory distress can occur in these infants due to aspiration or associated anomalies, but this is not the same as diaphragmatic breathing.

Passage of large amounts of frothy stool

Rationale: This symptom is unrelated to oesophageal atresia. Frothy stool might suggest gastrointestinal issues, but oesophageal atresia affects the upper digestive tract and does not directly cause changes in stool characteristics.

Conclusion:

Continuous drooling is the most specific and indicative sign of oesophageal atresia in a newborn. Early recognition of this condition is critical as it requires prompt medical intervention to prevent complications such as aspiration pneumonia and ensure proper feeding through alternative methods like a gastrostomy tube.