Atresia at the gastroesophageal junction associated with left congenital diaphragmatic hernia: a diagnostic and surgical challenge

Esophageal atresia (EA) and congenital diaphragmatic hernia (CDH) are commonly seen in paediatric surgical practice but their coexistence is rare. We present a case of a term male neonate with left CDH and atresia at the gastroesophageal (GE) junction. The patient underwent left CDH repair with gastroesophageal anastomosis in the same sitting. The postoperative course was turbulent with the patient developing sepsis and requiring ventilator support, which was successfully managed. Once feeds were started, an oral dye study revealed smooth transit of dye into the stomach. He was discharged and was well at 1, 3 and 6 months of follow-up. Management of such unique cases can be challenging and the surgeon should be ready for intraoperative surprises.