Oesophageal perforation in preterm neonates: Not an innocent bystander

Authors


  • Presented at the Annual Meeting of the Pediatric Academy Societies, Baltimore, MD, USA, May 2002.

Dr Prakesh S Shah, Department of Paediatrics, Room 775 A, Mount Sinai Hospital, 600 University Avenue, Toronto ON, Canada M5G 1 Ξ 5. Fax: 416 586 8745; email: pshah@mtsinai.on.ca

Abstract

Objective:  To compare the clinical course and neonatal outcomes of preterm infants with oesophageal perforation (OP).

Methods:  Retrospective case control study of infants admitted between 1994 and 2001 and diagnosed with OP was performed at two tertiary care centres in Toronto, Canada. One control per case was matched by the gestational age and the month of birth. Occurrence of air leak syndrome/pleural effusion requiring drainage, the duration of supplemental oxygen and the time to attain full feeds were compared.

Results:  Ten cases of OP were identified. The commonest clinical presentation was air leak syndrome/pleural effusion. There was a statistically significant increase in the time to attain full enteral feeds in OP group (P = 0.02). The duration of supplemental oxygen was prolonged in infants with OP, however, this was statistically insignificant (P = 0.20). The infants were managed conservatively and perforation healed in all.

Conclusion:  Oesophageal perforation is a rare but important complication of modern neonatal intensive care setting. The diagnosis of OP should be considered in infants who present with sudden/acute deterioration in their respiratory status following procedures involving pharyngeal region. Conservative management in an otherwise uncomplicated case leads to complete recovery in neonates.

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