We herein present an extremely rare case of an isolated membranous atresia causing near-complete obstruction of the esophagus. The neonate presented with drooling of saliva and frothing from the mouth. A red rubber catheter met with an obstruction at 12 cm from the gum margins. Radiograph showed paucity of gas in the abdomen. Thoracotomy revealed external continuity of esophagus; dilated and elongated proximal segment constituting upper half of esophagus, and a membrane with tiny opening in the center, at its junction with narrow distal segment. Excision was performed. A high index of suspicion for membrane should be kept in dealing with esophageal obstruction beyond 10 cm from the gum margins, particularly those with paucity of abdominal gas pattern or gasless abdomen.
Keywords: Esophageal atresia; Kluth type IV3; esophageal membrane; membranous obstruction; opening.