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Boletín Clínico de la Asociación Médica del Hospital Infantil del Estado de Sonora

2024, Number 1

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Bol Clin Hosp Infant Edo Son 2024; 41 (1)

Esophageal perforation in a premature infant. Case report

Pacheco BCF, López CG, Rodríguez GJ, López DAV, López DPS, Reyes GU, Quero HA, Reyes HKL, Navarro JBR, Navarro HCA

Language: Spanish
References: 23
Page: 64-67
PDF size: 196.97 Kb.


ABSTRACT

Esophageal perforation is a rare but important complication of the modern neonatal intensive care setting. Female patient of 31 weeks gestation is presented. Appropriate weight for gestational age. Respiratory distress syndrome secondary to hyaline membrane, early neonatal sepsis. At 24 hours of life she presented respiratory deterioration, thoracoabdominal radiography was performed showing left pneumothorax. He required endotracheal intubation and chest tube for the management of the pneumothorax. At 4 days of extrauterine life in phase III of ventilation, with pleural tube, the control thoracoabdominal radiography shows: anomalous trajectory of the polyvinyl orogastric tube towards the left pleural cavity, the contrasted study and direct exploration with laryngoscopy confirms esophageal perforation in the upper third of the esophagus. The patient was kept fasting for 6 days, initiating enteral trophic enteral stimulation by orogastric tube, every 3 hours, gradually increasing until nutritional requirements were reached, He is discharged due to improvement at 41 years of age. Iatrogenic causes of esophageal perforation include: difficult tracheal intubation, Non-surgical treatment is the first option in esophageal perforation. Pharyngoesophageal perforation occurs after traumatic placement of a polyvinyl feeding tube. The use of a silastic feeding tube instead of polyvinyl probes could probably prevent iatrogenic esophageal perforation.


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