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Oesophageal perforation presenting as oesophageal atresia in a premature neonate following difficult intubation
Iatrogenic oesophageal perforation in neonates is well recognized in the medical and surgical literature with intubation injury listed as a possible contributing mechanism besides nasogastric tube placement and suctioning. Diagnosis can be difficult and sometimes confused with other entities. With e...
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Published in: | Pediatric anesthesia 2001-01, Vol.11 (1), p.112-118 |
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container_title | Pediatric anesthesia |
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creator | Seefelder, C. Elango, S. Rosbe, K.W. Jennings, R.W. |
description | Iatrogenic oesophageal perforation in neonates is well recognized in the medical and surgical literature with intubation injury listed as a possible contributing mechanism besides nasogastric tube placement and suctioning. Diagnosis can be difficult and sometimes confused with other entities. With early diagnosis, nonsurgical management often leads to complete resolution in neonates. We report the case of a 1‐day‐old premature neonate who was brought to the operating room with the preliminary diagnosis of proximal oesophageal atresia with stump perforation and distal tracheo‐esophageal fistula. His intubation for respiratory distress at birth had been difficult due to Pierre–Robin sequence with micrognathia. Oesophagoscopy in the operating room revealed a patent oesophagus but perforations in the pharynx and in the proximal oesophagus with the nasogastric tube entering the pharyngeal perforation. Oesophageal perforation and the limitations of the difficult airway algorithm in small neonates are discussed. |
doi_str_mv | 10.1046/j.1460-9592.2001.00591.x |
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Diagnosis can be difficult and sometimes confused with other entities. With early diagnosis, nonsurgical management often leads to complete resolution in neonates. We report the case of a 1‐day‐old premature neonate who was brought to the operating room with the preliminary diagnosis of proximal oesophageal atresia with stump perforation and distal tracheo‐esophageal fistula. His intubation for respiratory distress at birth had been difficult due to Pierre–Robin sequence with micrognathia. Oesophagoscopy in the operating room revealed a patent oesophagus but perforations in the pharynx and in the proximal oesophagus with the nasogastric tube entering the pharyngeal perforation. Oesophageal perforation and the limitations of the difficult airway algorithm in small neonates are discussed.</description><identifier>ISSN: 1155-5645</identifier><identifier>EISSN: 1460-9592</identifier><identifier>DOI: 10.1046/j.1460-9592.2001.00591.x</identifier><identifier>PMID: 11123743</identifier><language>eng</language><publisher>Oxford UK: Blackwell Science Ltd</publisher><subject>anaesthesia ; Anesthesia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Diagnosis, Differential ; Diagnostic Errors ; Esophageal Atresia - diagnosis ; Esophageal Perforation - diagnosis ; Esophageal Perforation - etiology ; Esophagoscopy ; General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation ; Humans ; Infant, Newborn ; Infant, Premature, Diseases - diagnosis ; Intubation, Gastrointestinal - adverse effects ; Intubation, Intratracheal - adverse effects ; intubation: difficult intubation ; Laryngoscopy ; Male ; Medical sciences ; neonate ; oesophageal perforation ; Pharynx - injuries ; Pierre Robin Syndrome ; Radiography, Thoracic ; Tracheoesophageal Fistula - diagnosis ; tracheo–oesophageal fistula</subject><ispartof>Pediatric anesthesia, 2001-01, Vol.11 (1), p.112-118</ispartof><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3921-b2724f523b808e94da6f705d4f9580e32bb360b823be2bacec83339471088e4f3</citedby><cites>FETCH-LOGICAL-c3921-b2724f523b808e94da6f705d4f9580e32bb360b823be2bacec83339471088e4f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=888392$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11123743$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Seefelder, C.</creatorcontrib><creatorcontrib>Elango, S.</creatorcontrib><creatorcontrib>Rosbe, K.W.</creatorcontrib><creatorcontrib>Jennings, R.W.</creatorcontrib><title>Oesophageal perforation presenting as oesophageal atresia in a premature neonate following difficult intubation</title><title>Pediatric anesthesia</title><addtitle>Paediatr Anaesth</addtitle><description>Iatrogenic oesophageal perforation in neonates is well recognized in the medical and surgical literature with intubation injury listed as a possible contributing mechanism besides nasogastric tube placement and suctioning. Diagnosis can be difficult and sometimes confused with other entities. With early diagnosis, nonsurgical management often leads to complete resolution in neonates. We report the case of a 1‐day‐old premature neonate who was brought to the operating room with the preliminary diagnosis of proximal oesophageal atresia with stump perforation and distal tracheo‐esophageal fistula. His intubation for respiratory distress at birth had been difficult due to Pierre–Robin sequence with micrognathia. Oesophagoscopy in the operating room revealed a patent oesophagus but perforations in the pharynx and in the proximal oesophagus with the nasogastric tube entering the pharyngeal perforation. Oesophageal perforation and the limitations of the difficult airway algorithm in small neonates are discussed.</description><subject>anaesthesia</subject><subject>Anesthesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Diagnosis, Differential</subject><subject>Diagnostic Errors</subject><subject>Esophageal Atresia - diagnosis</subject><subject>Esophageal Perforation - diagnosis</subject><subject>Esophageal Perforation - etiology</subject><subject>Esophagoscopy</subject><subject>General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infant, Premature, Diseases - diagnosis</subject><subject>Intubation, Gastrointestinal - adverse effects</subject><subject>Intubation, Intratracheal - adverse effects</subject><subject>intubation: difficult intubation</subject><subject>Laryngoscopy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>neonate</subject><subject>oesophageal perforation</subject><subject>Pharynx - injuries</subject><subject>Pierre Robin Syndrome</subject><subject>Radiography, Thoracic</subject><subject>Tracheoesophageal Fistula - diagnosis</subject><subject>tracheo–oesophageal fistula</subject><issn>1155-5645</issn><issn>1460-9592</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><recordid>eNqNkE1r3DAQhkVJaT7av1AEhdzs6NMrQy8hpEkgND20ZzH2jlItWsuRbJL8-8rZJcmxJw3M886MHkIoZzVnqjnb1Fw1rGp1K2rBGK8Z0y2vnz6Qo9fGQam51pVulD4kxzlvCihFIz6RQ865kCslj0i8wxzHv3CPEOiIycUEk48DHRNmHCY_3FPINL6jYCotD9QPFBZsC9OckA4YB5iQuhhCfFxya--c7-cwFXSau5e5n8lHByHjl_17Qv78uPx9cV3d3l3dXJzfVr1sBa86sRLKaSE7wwy2ag2NWzG9Vq7VhqEUXScb1pkCoOigx95IKVu14swYVE6ekNPd3DHFhxnzZLc-9xgClDvnbMswpYUwBTQ7sE8x54TOjslvIT1bzuwi227s4tQuTu0i277Itk8l-nW_Y-62uH4L7u0W4NsegNxDcAmG3udXzhhTPluo7zvq0Qd8_u_19tf5z1LIf9Spm-0</recordid><startdate>200101</startdate><enddate>200101</enddate><creator>Seefelder, C.</creator><creator>Elango, S.</creator><creator>Rosbe, K.W.</creator><creator>Jennings, R.W.</creator><general>Blackwell Science Ltd</general><general>Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200101</creationdate><title>Oesophageal perforation presenting as oesophageal atresia in a premature neonate following difficult intubation</title><author>Seefelder, C. ; Elango, S. ; Rosbe, K.W. ; Jennings, R.W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3921-b2724f523b808e94da6f705d4f9580e32bb360b823be2bacec83339471088e4f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>anaesthesia</topic><topic>Anesthesia</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Diagnosis, Differential</topic><topic>Diagnostic Errors</topic><topic>Esophageal Atresia - diagnosis</topic><topic>Esophageal Perforation - diagnosis</topic><topic>Esophageal Perforation - etiology</topic><topic>Esophagoscopy</topic><topic>General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Premature, Diseases - diagnosis</topic><topic>Intubation, Gastrointestinal - adverse effects</topic><topic>Intubation, Intratracheal - adverse effects</topic><topic>intubation: difficult intubation</topic><topic>Laryngoscopy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>neonate</topic><topic>oesophageal perforation</topic><topic>Pharynx - injuries</topic><topic>Pierre Robin Syndrome</topic><topic>Radiography, Thoracic</topic><topic>Tracheoesophageal Fistula - diagnosis</topic><topic>tracheo–oesophageal fistula</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Seefelder, C.</creatorcontrib><creatorcontrib>Elango, S.</creatorcontrib><creatorcontrib>Rosbe, K.W.</creatorcontrib><creatorcontrib>Jennings, R.W.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Seefelder, C.</au><au>Elango, S.</au><au>Rosbe, K.W.</au><au>Jennings, R.W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Oesophageal perforation presenting as oesophageal atresia in a premature neonate following difficult intubation</atitle><jtitle>Pediatric anesthesia</jtitle><addtitle>Paediatr Anaesth</addtitle><date>2001-01</date><risdate>2001</risdate><volume>11</volume><issue>1</issue><spage>112</spage><epage>118</epage><pages>112-118</pages><issn>1155-5645</issn><eissn>1460-9592</eissn><abstract>Iatrogenic oesophageal perforation in neonates is well recognized in the medical and surgical literature with intubation injury listed as a possible contributing mechanism besides nasogastric tube placement and suctioning. Diagnosis can be difficult and sometimes confused with other entities. With early diagnosis, nonsurgical management often leads to complete resolution in neonates. We report the case of a 1‐day‐old premature neonate who was brought to the operating room with the preliminary diagnosis of proximal oesophageal atresia with stump perforation and distal tracheo‐esophageal fistula. His intubation for respiratory distress at birth had been difficult due to Pierre–Robin sequence with micrognathia. Oesophagoscopy in the operating room revealed a patent oesophagus but perforations in the pharynx and in the proximal oesophagus with the nasogastric tube entering the pharyngeal perforation. Oesophageal perforation and the limitations of the difficult airway algorithm in small neonates are discussed.</abstract><cop>Oxford UK</cop><pub>Blackwell Science Ltd</pub><pmid>11123743</pmid><doi>10.1046/j.1460-9592.2001.00591.x</doi><tpages>7</tpages></addata></record> |
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subjects | anaesthesia Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Diagnosis, Differential Diagnostic Errors Esophageal Atresia - diagnosis Esophageal Perforation - diagnosis Esophageal Perforation - etiology Esophagoscopy General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation Humans Infant, Newborn Infant, Premature, Diseases - diagnosis Intubation, Gastrointestinal - adverse effects Intubation, Intratracheal - adverse effects intubation: difficult intubation Laryngoscopy Male Medical sciences neonate oesophageal perforation Pharynx - injuries Pierre Robin Syndrome Radiography, Thoracic Tracheoesophageal Fistula - diagnosis tracheo–oesophageal fistula |
title | Oesophageal perforation presenting as oesophageal atresia in a premature neonate following difficult intubation |
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