Luca Filippi1, Marco Pezzati, Chiara Poggi. 1. Neonatal Intensive Care Unit, Department of Critical Care Medicine, University Careggi Hospital, Florence, Italy. filippi.luca@virgilio.it
Abstract
BACKGROUND: Placement of a feeding tube may be associated with various complications, including iatrogenic pharyngo-oesophageal perforation. AIM: To determine the incidence of pharyngo-oesophageal perforation secondary to the use of polyvinyl feeding tubes in newborns weighing less than 1500 g, we conducted a retrospective study over a 3(1/2)-y period. METHODS: All the hospital files of the 371 very-low-birthweight newborns admitted were retrospectively reviewed. RESULTS: Three iatrogenic pharyngo-oesophageal perforations were observed, giving an incidence of 1:124 preterm infants. This incidence reaches values of 1:25 newborns weighing less than 750 g. Data from our cases included clinical presentation and outcome, radiological evaluation, and type of feeding tube. One infant died of sepsis, and the clinical course was compatible with mediastinitis. The other two infants were treated successfully with conservative non-surgical management. CONCLUSION: Pharyngo-oesophageal perforation in our experience exclusively involved preterm infants weighing less than 750 g after traumatic placement of a polyvinyl feeding tube. The use of a silastic feeding tube with a really soft end instead of polyvinyl catheters could probably avoid iatrogenic oesophageal perforation.
BACKGROUND: Placement of a feeding tube may be associated with various complications, including iatrogenic pharyngo-oesophageal perforation. AIM: To determine the incidence of pharyngo-oesophageal perforation secondary to the use of polyvinyl feeding tubes in newborns weighing less than 1500 g, we conducted a retrospective study over a 3(1/2)-y period. METHODS: All the hospital files of the 371 very-low-birthweight newborns admitted were retrospectively reviewed. RESULTS: Three iatrogenic pharyngo-oesophageal perforations were observed, giving an incidence of 1:124 preterm infants. This incidence reaches values of 1:25 newborns weighing less than 750 g. Data from our cases included clinical presentation and outcome, radiological evaluation, and type of feeding tube. One infant died of sepsis, and the clinical course was compatible with mediastinitis. The other two infants were treated successfully with conservative non-surgical management. CONCLUSION: Pharyngo-oesophageal perforation in our experience exclusively involved preterm infants weighing less than 750 g after traumatic placement of a polyvinyl feeding tube. The use of a silastic feeding tube with a really soft end instead of polyvinyl catheters could probably avoid iatrogenic oesophageal perforation.
Authors: Lukas P Mileder; Martin Müller; Friedrich Reiterer; Alexander Pilhatsch; Barbara Gürtl-Lackner; Berndt Urlesberger; Wolfgang Raith Journal: Case Rep Pediatr Date: 2016-10-10
Authors: Jonathan Goring; Ashok Raghavan; Ravi Thevasagayam; Elizabeth Pilling; Elizabeth Shepherd; Govind V Murthi Journal: J Indian Assoc Pediatr Surg Date: 2020-10-27