Abstract
Esophageal perforations in newborns can occur for a multitude of reasons and are best classified as iatrogenic or spontaneous. Spontaneous perforation is extremely rare and more commonly encountered in full-term infants. Iatrogenic perforations are more often seen in premature, small for gestational age infants and usually occur in the cervical esophagus or hypopharynx. Frequent causes for iatrogenic perforation include pharyngeal suctioning, laryngoscopy, attempted esophageal intubation, and digital manipulation of the neonatal head during breech delivery.
With early diagnosis and close monitoring, even more distally located iatrogenic perforations can often be managed conservatively with good outcomes. Early diagnosis of this condition allows for further surgical treatment options such as closed-chest drainage, primary repair, or stenting. Delayed diagnosis may result in the inability to repair the injury primarily, a significant increase in mortality, and the eventual need for esophageal replacement among survivors.
Keywords
Esophageal perforation Boerhaave’s syndrome Cervical esophagus Hypopharynx Hydropneumothorax Pneumomediastinum Esophagography ThoracostomyReferences
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