Abstract
Background Esophageal perforation in neonates occurs most often in cases of extreme prematurity and is commonly due to iatrogenic causes. Treatment over recent decades has become more conservative. The purpose of this study was to review cases of esophageal perforation in neonates and to describe the presentation, management, and outcomes. Materials and methods A retrospective chart review was performed for patients with International Classification of Diseases, Ninth Revision code for esophageal perforation treated at our institution between the years 2009 and 2015. Data collected included demographic information, etiology of perforation (specifically focusing on cases secondary to orogastric tube placement), treatment course, time to resumption of enteral feeds, length of antibiotic use, time to subsequent radiographic resolution, and mortality. Results Twenty-five patients met study criteria. The average post-conceptual age at time of diagnosis was 26.5 ± 2.3 wk. All 25 patients were managed nonoperatively with bowel rest, parenteral nutrition, and broad-spectrum antibiotics. Enteral feeds were resumed after a median of 8 d (interquartile range [IQR]: 7-11), the median antibiotic duration was 7 d (IQR: 7-10), and the median time to follow-up esophagram was 7 d (IQR: 7-10). Overall, 24 of 25 patients (96%) demonstrated radiological resolution of perforation on initial follow-up esophagram. Four patients died during the study period, but no deaths were related to the diagnosis of esophageal perforation. Conclusions In this largest reported sample of neonates treated for esophageal perforation, nonoperative management with bowel rest, parenteral nutrition, and antibiotics was successful.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 102-107 |
| Number of pages | 6 |
| Journal | Journal of Surgical Research |
| Volume | 205 |
| Issue number | 1 |
| DOIs | |
| State | Published - Sep 1 2016 |
| Externally published | Yes |
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Keywords
- Esophageal perforation
- Iatrogenic
- Neonatal
ASJC Scopus subject areas
- Surgery
Cite this
Nonoperative management of esophageal perforations in the newborn. / Onwuka, Ekene A.; Saadai, Payam; Boomer, Laura A.; Nwomeh, Benedict C.
In: Journal of Surgical Research, Vol. 205, No. 1, 01.09.2016, p. 102-107.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Nonoperative management of esophageal perforations in the newborn
AU - Onwuka, Ekene A.
AU - Saadai, Payam
AU - Boomer, Laura A.
AU - Nwomeh, Benedict C.
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Background Esophageal perforation in neonates occurs most often in cases of extreme prematurity and is commonly due to iatrogenic causes. Treatment over recent decades has become more conservative. The purpose of this study was to review cases of esophageal perforation in neonates and to describe the presentation, management, and outcomes. Materials and methods A retrospective chart review was performed for patients with International Classification of Diseases, Ninth Revision code for esophageal perforation treated at our institution between the years 2009 and 2015. Data collected included demographic information, etiology of perforation (specifically focusing on cases secondary to orogastric tube placement), treatment course, time to resumption of enteral feeds, length of antibiotic use, time to subsequent radiographic resolution, and mortality. Results Twenty-five patients met study criteria. The average post-conceptual age at time of diagnosis was 26.5 ± 2.3 wk. All 25 patients were managed nonoperatively with bowel rest, parenteral nutrition, and broad-spectrum antibiotics. Enteral feeds were resumed after a median of 8 d (interquartile range [IQR]: 7-11), the median antibiotic duration was 7 d (IQR: 7-10), and the median time to follow-up esophagram was 7 d (IQR: 7-10). Overall, 24 of 25 patients (96%) demonstrated radiological resolution of perforation on initial follow-up esophagram. Four patients died during the study period, but no deaths were related to the diagnosis of esophageal perforation. Conclusions In this largest reported sample of neonates treated for esophageal perforation, nonoperative management with bowel rest, parenteral nutrition, and antibiotics was successful.
AB - Background Esophageal perforation in neonates occurs most often in cases of extreme prematurity and is commonly due to iatrogenic causes. Treatment over recent decades has become more conservative. The purpose of this study was to review cases of esophageal perforation in neonates and to describe the presentation, management, and outcomes. Materials and methods A retrospective chart review was performed for patients with International Classification of Diseases, Ninth Revision code for esophageal perforation treated at our institution between the years 2009 and 2015. Data collected included demographic information, etiology of perforation (specifically focusing on cases secondary to orogastric tube placement), treatment course, time to resumption of enteral feeds, length of antibiotic use, time to subsequent radiographic resolution, and mortality. Results Twenty-five patients met study criteria. The average post-conceptual age at time of diagnosis was 26.5 ± 2.3 wk. All 25 patients were managed nonoperatively with bowel rest, parenteral nutrition, and broad-spectrum antibiotics. Enteral feeds were resumed after a median of 8 d (interquartile range [IQR]: 7-11), the median antibiotic duration was 7 d (IQR: 7-10), and the median time to follow-up esophagram was 7 d (IQR: 7-10). Overall, 24 of 25 patients (96%) demonstrated radiological resolution of perforation on initial follow-up esophagram. Four patients died during the study period, but no deaths were related to the diagnosis of esophageal perforation. Conclusions In this largest reported sample of neonates treated for esophageal perforation, nonoperative management with bowel rest, parenteral nutrition, and antibiotics was successful.
KW - Esophageal perforation
KW - Iatrogenic
KW - Neonatal
UR - http://www.scopus.com/inward/record.url?scp=84977160703&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84977160703&partnerID=8YFLogxK
U2 - 10.1016/j.jss.2016.06.027
DO - 10.1016/j.jss.2016.06.027
M3 - Article
C2 - 27621005
AN - SCOPUS:84977160703
VL - 205
SP - 102
EP - 107
JO - Journal of Surgical Research
JF - Journal of Surgical Research
SN - 0022-4804
IS - 1
ER -