Selective management of iatrogenic esophageal perforation in the newborn

A Rare Case of Accidental Esophageal Perforation in an Extremely Low Birth Weight Neonate

“…Neonates with iatrogenic pharyngo-oesophageal perforation should be treated according to the severity and presentation in each individual case. Removal of the nasogastric tube, initiation of broad spectrum antibiotics and provision of parenteral nutrition / gastrostomy feeds for 7-10 days provides adequate treatment in most cases [9,11]. Most babies can be treated conservatively although surgical intervention may be required in severe cases [11,12].There is no difference in the reported rate of survival when treated medically versus surgically [9].…”

“…Removal of the nasogastric tube, initiation of broad spectrum antibiotics and provision of parenteral nutrition / gastrostomy feeds for 7-10 days provides adequate treatment in most cases [9,11]. Most babies can be treated conservatively although surgical intervention may be required in severe cases [11,12].There is no difference in the reported rate of survival when treated medically versus surgically [9]. Routine surgical intervention does not improve the survival and should be restricted for patients with mediastinitis or mediastinal mass [9].…”

Traumatic retropharyngeal emphysema as a cause for severe respiratory distress in a newborn

“…Complications such as pneumothorax, pleural effusion or pericardial effusion may require appropriate intervention. Severe injuries may need surgical repair [1,2,3,4,5,6,7,8,9,13]. In our patient, a nasogastric tube was placed and the patient was nourished through it for 8 days until the retropharyngeal emphysema was no longer demonstrated.…”

Iatrogenic Esophageal Perforation: An Occurrence from Feeding Tube Placement in a Premature Infant with a Pneumothorax

“…The choice of treatment varies ac cording to the cause and specific location of the perforation and the time to recognition 16) . However, controversy exists as to the appropriateness of conservative management (prophylactic antibiotics, parenteral nutrition and chest drainage) versus surgical correction, with the former being more advocated 7,19) . In our case, conservative management was successful.…”