Iatrogenic Perforation of Upper Pouch in Pure Esophageal Atresia: A Rare Complication and Review of Literature

Abstract

Iatrogenic perforation of the neonate's pharynx and esophagus with normal anatomy was first described by Eklöf et al in 1968. It typically occurs in severely premature neonates who have undergone repeated traumatic attempts at endotracheal intubation or passage of orogastric tubes. It may also mimic esophageal atresia (EA). Perforation of upper pouch in tracheoesophageal fistula with EA was rarely reported. We report a 1,400 g (32 weeks) neonate with pure EA and iatrogenic perforation of upper pouch due to use of catheter for diagnostic radiography.

Tracheoesophageal fistula with complex injury to the existing anomaly - Youngest neonate to survive: A case report

“…[7,8,10] Iatrogenic injuries caused during the management of this special group of VLBW babies with TEF had brought poor survival in the past (Table 1). [9][10][11][12][13][14] The sites of injury in these 5 cases were the upper pouch in 3, posterior pharyngeal wall in 1, and trachea at the level of fistula in 1. The case presented had a complex tracheoesophageal injury involving the upper pouch, trachea, and fistula which has not been published.…”

Kluth type iiib6esophageal atresia: Diagnostic dilemma and pitfalls of using infant feeding tube

“…This test should be performed by trained personnel, taking care to prevent esophageal injury or perforation. [ 9 ] For prematures, smaller sized catheter must be used.…”

Pneumomediastinum following iatrogenic pharyngeal perforation during tracheoesophageal fistula repair

“…reported iatrogenic perforation of the proximal pouch in pure esophageal atresia leading to pneumothorax which required ventilator support with right ICD. [ 4 ] Ben Aoun et al . reported a case of esophageal perforation mimicking esophageal atresia resulting in negative thoracotomy.…”