{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:02:55Z","timestamp":1756425775060,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,4,16]]},"abstract":"<jats:p>We present a case of triple gut atresias (foregut, midgut and hindgut) with multiple congenital anomalies presenting as imperforate anus. Abdominal radiography showed the double bubble sign. Upper gastrointestinal study through a nasogastric tube confirmed duodenal obstruction. Exploratory laparotomy, duodeno-duodenostomy for duodenal atresia and a left descending colostomy for anorectal malformation were performed. During extubation, the nasogastric tube came out and could not be reinserted by the anaesthetic team under laryngoscopic guidance. A chest radiograph showed the tube curled in the upper pouch. Bronchoscopy and oesophagoscopy confirmed oesophageal atresia (OA) with a distal tracheoesophageal fistula (TOF). The patient underwent right-sided extrapleural thoracotomy and division of the fistula with primary repair of OA uneventfully. Triple gut atresias presenting in reverse order with multiple anomalies is rare and passage of a nasogastric tube into the stomach in the presence of OA+TOF is exceptional. Alimentary tract obstruction should be corrected in proximal to distal direction.<\/jats:p>","DOI":"10.1136\/bcr-2014-204171","type":"journal-article","created":{"date-parts":[[2014,5,16]],"date-time":"2014-05-16T09:40:50Z","timestamp":1400233250000},"page":"bcr2014204171","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Trilogy of foregut, midgut and hindgut atresias presenting in reverse order"],"prefix":"10.1136","volume":"2014","author":[{"given":"Ramnik V","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Paediatric Urology, University College London Hospitals NHS Foundation Trust, London, UK"},{"name":"Department of Paediatric Urology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Jackson","sequence":"additional","affiliation":[{"name":"Neonatal and Paediatric Surgery, GOSH and ICH, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"De Coppi","sequence":"additional","affiliation":[{"name":"Neonatal and Paediatric Surgery, GOSH and ICH, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agostino","family":"Pierro","sequence":"additional","affiliation":[{"name":"Neonatal and Paediatric Surgery, GOSH and ICH, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,5,16]]},"reference":[{"key":"2025082800413690000_2014.may15_1.bcr2014204171.1","doi-asserted-by":"crossref","unstructured":"Patel RV Kumar H More B . 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Published Online 29 July 2013. doi: 10.1136\/bcr-2013-200198","DOI":"10.1136\/bcr-2013-200198"},{"key":"2025082800413690000_2014.may15_1.bcr2014204171.4","doi-asserted-by":"crossref","unstructured":"Patel RV Jackson PB De Coppi P . Exclusion of oesophageal atresia by passage of a nasogastric tube: an exception to the rule. BMJ Case Rep 2013. doi: 10.1136\/bcr-2013-201175","DOI":"10.1136\/bcr-2013-201175"},{"key":"2025082800413690000_2014.may15_1.bcr2014204171.5","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2000.6049"},{"key":"2025082800413690000_2014.may15_1.bcr2014204171.6","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/j.jpedsurg.2005.11.061","article-title":"Babies with esophageal and duodenal atresia: a 30 year review of a multifaceted problem","volume":"42","author":"Ein","year":"2006","journal-title":"J Pediatric Surg"},{"key":"2025082800413690000_2014.may15_1.bcr2014204171.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2011.09.047"},{"key":"2025082800413690000_2014.may15_1.bcr2014204171.8","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.epsc.2013.03.009","article-title":"Association of duodenal and biliary atresias in Martinez\u2013Frias Syndrome: a very rare case","volume":"1","author":"Savran","year":"2013","journal-title":"J Pediatr Surg Case Reports"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2014-204171","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:41:45Z","timestamp":1756366905000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2014-204171"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,5,16]]},"references-count":8,"alternative-id":["10.1136\/bcr-2014-204171"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2014-204171","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2014,5,16]]}}}