Iatrogenic esophageal perforation in the neonate.
Keywords:
Esophageal perforation- NeonateAbstract
Background: Esophageal perforation is uncommon and often iatrogenic.Aim: To report a neonatal case of esophageal perforation.
Case: A premature newborn boy was admitted with a diagnosis of oesophageal atresia after several unsuccessful attempts to insert an orogastric tube. A chest x-ray showed a “high pouch” with a gasless intestine. At operation, no atresia was found and a large traumatic perforation of the lower cervical segment was identified, requiring cervicotomy and primary closure. Oral feeding was started after 3 weeks. As a result, nosocomial sepsis occurred, causing death in the third month after surgical treatment.
Conclusion: Oesophageal perforation in the neonate is often iatrogenic and may mimic oesophageal atresia. The authors highlight the importance of early diagnosis and management.
Downloads
References
Blair GK, Filler RM, Theodorescu D. Neonatal pharyngooesophageal perforation mimicking oesophageal atresia: clues to diagnosis. J Pediatr Surg 1987; 22: 770-4.
Bonnard A, Carricaburu E, Sapin E. Neonatal iatrogenic pharyngo-oesophageal perforation. Arch Pediatr 1997; 4: 737- 43.
Sapin E. Iatrogenic esophageal perforations in the newborn. Arch Pediatrie 2003; 10: 374-8.
Su BH, Lin HY, Chiu HY, Lin HC. Oesophageal perforation: a complication of nasogastric tube placement in premature infants. J Pediatr 2009; 154: 460.
Emil SGS. Neonatal esophageal perforation. J Pediatr Surg 2004; 39: 1296-8.
Soong WJ. Endoscopic diagnosis and management of iatrogenic cervical oesophageal perforation in extremely premature infants. J Chin Med Assoc 2007; 70: 171-5.
Martinez L, Rivas S, Hernadez F et al. Aggressive conservative treatment of esophageal perforations in children. J Pediatr Surg 2003; 38: 685-9.
Krasna IH, Rosenfeld D, Benjamin BG, Klein G, Hiatt M, Hegyi T. Oesophageal perforation in the neonate: an emerging problem in the newborn nursery. J Pediatr Surg 1987; 22: 784-90.
Panieri E, Millar AJW, Rode H, Brown RA, Cywes S. Iatrogenic oesophageal perforation in children: patterns of injury, presentation, management and outcome. J Pediatr Surg 1996; 31: 890-5.
