Misplaced gastric tube: a case of oesophageal perforation in a preterm neonate

A 25-week infant, born in a level one unit, was intubated, ventilated and transferred to the tertiary neonatal centre without incident. He had acute respiratory collapse on day 2 with a right-sided tension pneumothorax (figure 1A), which was drained. He remained stable until day 7 when he deteriorated, with increased oxygen requirement and poor feed tolerance (figure 1B). On review, there were gastric tube aspirates over the preceding days with high pH (>6–8), consisting mainly of large volumes of undigested milk. Questions What do these radiographs show? What is your differential diagnosis? What would your concerns be? How would you manage this? Answers can be found on page 2. ANSWERS TO THE QUESTIONS ON PAGE 1Answers The first image shows a right-sided tension pneumothorax. The gastric tube tip projects high, over the lower oesophagus. The...
Source: Archives of Disease in Childhood - Education and Practice - Category: Pediatrics Authors: Tags: Epilogue Source Type: research