Esophageal perforation in preterm neonates: A complication to remember

Vikram Singhal, Nutan Kamath, Rathika D. Shenoy

Research output: Contribution to journalArticlepeer-review

Abstract

Background and aim: Esophageal perforation (EP), a hole in the esophagus - the tube through which food passes from the mouth to the stomach, is a well-known entity in adults, while it is relatively uncommon in infants and children. Instrumental perforation and spontaneous perforation remain the 2 major causes of esophageal injury in infants and children. EP due to instrumentation is a life-threatening complication. Incidences of morbidity and mortality are directly related to delays in diagnosis and treatment. In the newborns, EP may be iatrogenic or noniatrogenic. We herein report our experience with the successful management of this complication in an infant. Materials and methods: In this study, a 32-week preterm infant small for gestational age (SGA) was ventilated for hyaline membrane disease at the Department of Pediatrics, KMC Hospital (Attavar, Mangalore). The infant presented with fresh bleed during the change of blocked endotracheal tube with sudden cardiopulmonary deterioration and right-sided tension pneumothorax. In addition, a chest radiograph revealed coiling of the feeding tube in the right pleural cavity suggestive of EP. An infant feeding tube of 5 Fr (nasogastric tube) was passed into the stomach. An intercostal, extrapleural drain was then positioned close to the anastomosis. The nasogastric tube was removed after 10 days. The infant was managed conservatively throughout the study period. Results: Upon a 9 year follow-up, the infant was found to be doing well with no evidence of esophageal stricture. Conclusion: The patient was successfully treated using conservative measures.

Original languageEnglish
Pages (from-to)119-121
Number of pages3
JournalPerinatology
Volume13
Issue number3
Publication statusPublished - 01-10-2012

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynaecology

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