IATROGENIC ESOPHAGEAL-PERFORATION IN PREM ATURE-INFANTS - A REPORT OF3 CASES

Three cases of iatrogenic esophageal perforation seen in premature inf ants over the last three years are reported. The cause was a gastric c atheter inserted through the mouth. Although only very few similar cas es have been reported in the literature, the frequency of this complic ation is probably underestimated. Ventilatory assistance usually precl udes clinical diagnosis. On plain roentgenograms, a right pneumothorax and an abnormal position of the catheter are suggestive. Management r elies on broad spectrum parenteral antimicrobials, total parenteral nu trition, and, if needed, drainage of the air and fluid effusion. After about 14 days, an esogastroduodenal radiologic study is performed and a gastric catheter is inserted under fluoroscopic guidance. Enteral n utrition can then be resumed. Iatrogenic esophageal perforation is usu ally not responsible for local sequelae or death but occurs in infants with a high risk of death due to prematurity and growth retardation.