We read with pleasure Buchheit's1 article comparing the clinical findings in 21 preterm infants with localized intestinal perforation (LP) versus those of 21 preterm infants with intestinal perforation secondary to necrotizing enterocolitis (NEC). However, we would be grateful if the authors would clarify two points:
1. How are their 21 cases of LP different from the >500 cases of idiopathic gastrointestinal perforation reviewed by Lloyd in 1979?2
2. The authors hypothesized that the placement of midthoracic umbilical artery catheters (UACs) would be a significant factor in the etiology of LP.
OBJECTIVE: The most severe form of generalized junctional epidermolysis bullosa, the Herlitz variant, is associated with a number of extracutaneous manifestations. We report on a 45-day-old infant with laryngotracheobronchial mucosa involvement who underwent successful tracheal extubation after 10 days of orotracheal intubation and mechanical ventilatory support. Issues regarding airway management and mechanical ventilatory support in the pediatric intensive care unit are discussed.
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