Iatrogenic Pharyngoesophageal Perforation In The Neonatal Period – Clues For Conservative Treatment
Journal: International Journal of Surgery and Medicine (IJSM) (Vol.3, No. 2)Publication Date: 2017-04-30
Authors : Ognyan Brankov Hristo Shivachev Daniela Antonova Yanko Pahnev;
Page : 107-110
Keywords : iatrogenic pharyngoesophageal perforation; conservative treatment; neonatal surgery;
Abstract
Introduction: Iatrogenic perforation of the oesophagus in neonates is a rare condition, and it is most frequently seen in low birth weight infants. The commonly reported symptoms of these incidents are sudden onset respiratory distress and failure of endonasal feeding. Our series present an example of difficult nasogastric tube insertion followed by its stoppage at different thoracic levels, and failure to reach the abdomen as well as haemorrhage from the tube lumen. Material and Methods: Five premature infants suspected for the surgical pathology of the oesophagus are retrospectively discussed. Contrast chest X-ray was enough to establish the diagnosis. Clinical observation and intensive care were our first therapeutic method of choice. Results: In two cases the contrast material revealed a contrast depot parallel to the oesophagal lumen up to a point overlying the diaphragm, initially misdiagnosed for tubular duplication of the oesophagus. In another two cases, the contrast X-ray examination showed a normal oesophagal lumen with diverticulum-like enlargement in the upper third, initially misinterpreted as oesophagal atresia. The last case presented with pneumomediastinum and subcutaneous emphysema followed by apnea that required mechanical ventilation. Conclusion: Iatrogenic neonatal pharyngoesophageal perforation (PhEP) is a rare complication in the modern neonatal intensive care. Most cases can be treated conservatively; nevertheless, surgery presents an emergency option in severe cases. The correct interpretation of the X-ray image based on the previous history and clinical symptoms are crucial for the choice of the approach to appropriate treatments.
Other Latest Articles
- Treatment of distal humerus fractures with Extra-articular Locking Compression Plate technique
- Reamed versus unreamed intramedullary nailing in the treatment of elderly pertrochanteric femoral fractures: evaluation of the systemic inflammatory response and organ dysfunction
- Laparoscopic cholecystectomy as a day surgery operation: two centers experience
- Optimising resources for surgical procedures in Low resource settings: an Ontological Analysis
- Comparison of the diagnostic accuracies of four main otoscopic examination methods
Last modified: 2018-02-03 17:34:21