Clinical Features of iatrogenic Pharyngo-esophageal perforation in very low birth weight infants
Background: Iatrogenic pharyngoesophageal perforation (IPEP) is one of the complications of gastric tube insertion and it tends to occur more frequently in premature infants. Although the frequency is significantly low, attention should be paid as it can lead to serious outcomes with high mortality....
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Elsevier
2025-01-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S187595722400072X |
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| author | Shu Eguchi Yoshiya Hisaeda Toshiko Ukawa Mayu Koto Miku Hosokawa Chisa Tsurisawa Tomohiro Takeda Shusuke Amagata Atsushi Nakao |
| author_facet | Shu Eguchi Yoshiya Hisaeda Toshiko Ukawa Mayu Koto Miku Hosokawa Chisa Tsurisawa Tomohiro Takeda Shusuke Amagata Atsushi Nakao |
| author_sort | Shu Eguchi |
| collection | DOAJ |
| description | Background: Iatrogenic pharyngoesophageal perforation (IPEP) is one of the complications of gastric tube insertion and it tends to occur more frequently in premature infants. Although the frequency is significantly low, attention should be paid as it can lead to serious outcomes with high mortality. This study will help raise awareness with respect to early diagnosis, management, and prevention. Methods: We performed a retrospective cohort study of all very low birth weight infants diagnosed with IPEP between 1993 and 2022. Results: A total of 6 patients (0.27% of very low birth weight infants) with the diagnosis of IPEP were included. The median gestational age was 27 + 1 weeks (range 23+5–28 + 6 weeks), and the median birth weight was 823 g (range 630–1232 g). Symptoms included difficulty with gastric tube insertion, bloody secretions in the oral cavity, and increased oral secretions. X-rays revealed aberrant running of the gastric tube in all patients. In three cases, contrast studies demonstrated contrasted mediastinum tapering like a bead. Laryngoscope was used to view the perforation sites but this was not useful in the smallest patient. All patients were treated conservatively with antibiotics and survived. Conclusions: When inserting a gastric tube for premature infants, it is critical to remember that these infants are at risk of IPEP. In addition to a frontal X-ray, a lateral X-ray and contrast study may be useful for early diagnosis. |
| format | Article |
| id | doaj-art-b509eab4419f4f859564978c601e6196 |
| institution | Kabale University |
| issn | 1875-9572 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj-art-b509eab4419f4f859564978c601e61962025-01-25T04:11:03ZengElsevierPediatrics and Neonatology1875-95722025-01-016612530Clinical Features of iatrogenic Pharyngo-esophageal perforation in very low birth weight infantsShu Eguchi0Yoshiya Hisaeda1Toshiko Ukawa2Mayu Koto3Miku Hosokawa4Chisa Tsurisawa5Tomohiro Takeda6Shusuke Amagata7Atsushi Nakao8Corresponding author.; Department of Neonatology, Japanese Red Cross Medical Center, Tokyo, Japan, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, JapanDepartment of Neonatology, Japanese Red Cross Medical Center, Tokyo, Japan, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, JapanDepartment of Neonatology, Japanese Red Cross Medical Center, Tokyo, Japan, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, JapanDepartment of Neonatology, Japanese Red Cross Medical Center, Tokyo, Japan, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, JapanDepartment of Neonatology, Japanese Red Cross Medical Center, Tokyo, Japan, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, JapanDepartment of Neonatology, Japanese Red Cross Medical Center, Tokyo, Japan, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, JapanDepartment of Neonatology, Japanese Red Cross Medical Center, Tokyo, Japan, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, JapanDepartment of Neonatology, Japanese Red Cross Medical Center, Tokyo, Japan, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, JapanDepartment of Neonatology, Japanese Red Cross Medical Center, Tokyo, Japan, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, JapanBackground: Iatrogenic pharyngoesophageal perforation (IPEP) is one of the complications of gastric tube insertion and it tends to occur more frequently in premature infants. Although the frequency is significantly low, attention should be paid as it can lead to serious outcomes with high mortality. This study will help raise awareness with respect to early diagnosis, management, and prevention. Methods: We performed a retrospective cohort study of all very low birth weight infants diagnosed with IPEP between 1993 and 2022. Results: A total of 6 patients (0.27% of very low birth weight infants) with the diagnosis of IPEP were included. The median gestational age was 27 + 1 weeks (range 23+5–28 + 6 weeks), and the median birth weight was 823 g (range 630–1232 g). Symptoms included difficulty with gastric tube insertion, bloody secretions in the oral cavity, and increased oral secretions. X-rays revealed aberrant running of the gastric tube in all patients. In three cases, contrast studies demonstrated contrasted mediastinum tapering like a bead. Laryngoscope was used to view the perforation sites but this was not useful in the smallest patient. All patients were treated conservatively with antibiotics and survived. Conclusions: When inserting a gastric tube for premature infants, it is critical to remember that these infants are at risk of IPEP. In addition to a frontal X-ray, a lateral X-ray and contrast study may be useful for early diagnosis.http://www.sciencedirect.com/science/article/pii/S187595722400072XEsophageal perforationGastric feeding tubeIatrogenic diseaseNeonatal intensive care unitVery low birth weight infants |
| spellingShingle | Shu Eguchi Yoshiya Hisaeda Toshiko Ukawa Mayu Koto Miku Hosokawa Chisa Tsurisawa Tomohiro Takeda Shusuke Amagata Atsushi Nakao Clinical Features of iatrogenic Pharyngo-esophageal perforation in very low birth weight infants Pediatrics and Neonatology Esophageal perforation Gastric feeding tube Iatrogenic disease Neonatal intensive care unit Very low birth weight infants |
| title | Clinical Features of iatrogenic Pharyngo-esophageal perforation in very low birth weight infants |
| title_full | Clinical Features of iatrogenic Pharyngo-esophageal perforation in very low birth weight infants |
| title_fullStr | Clinical Features of iatrogenic Pharyngo-esophageal perforation in very low birth weight infants |
| title_full_unstemmed | Clinical Features of iatrogenic Pharyngo-esophageal perforation in very low birth weight infants |
| title_short | Clinical Features of iatrogenic Pharyngo-esophageal perforation in very low birth weight infants |
| title_sort | clinical features of iatrogenic pharyngo esophageal perforation in very low birth weight infants |
| topic | Esophageal perforation Gastric feeding tube Iatrogenic disease Neonatal intensive care unit Very low birth weight infants |
| url | http://www.sciencedirect.com/science/article/pii/S187595722400072X |
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