Congenital high airway obstruction syndrome (CHAOS) combined with esophageal atresia, tracheoesophageal fistula and duodenal atresia

Congenital high airway obstruction syndrome (CHAOS) is a rare congenital anomaly and the most common etiology is laryngeal atresia. Recently, an increasing number of cases have survived due to prenatal diagnosis and pre- and peri-natal care including ex-utero intrapartum treatment (EXIT). More than 100 cases of CHAOS have been reported, and about half of them were complicated with associated anomalies. Here we report a very rare case of prenatally diagnosed CHAOS (laryngeal atresia) complicated with esophageal atresia, tracheoesophageal fistula (TEF) and duodenal atresia, and the patient was saved by EXIT. This combination of anomalies resulted in a very confusing prenatal diagnosis with unique imaging feature of the fetus.