Jones Katherine Elizabeth, Wagener Silke, Willetts Ian Edward, Lakhoo Kokila
West Wing, Children's Hospital, John Radcliffe Hospital, Oxford, UK.
BMJ Case Rep. 2012 May 23;2012:bcr1120115261. doi: 10.1136/bcr.11.2011.5261.
Management of oesophageal perforation in extremely premature babies is a challenge and carries a high morbidity. The authors report their experience of three separate cases of oesophageal perforation they encountered over the last 18 months in extremely premature neonates. In the first case, the diagnosis of oesophageal perforation was known in an otherwise stable baby who was treated conservatively with a good outcome. In the second and third cases, the patients proceeded to thoracotomy before the diagnosis of a perforated oesophagus was unveiled. A subsequent diagnosis of trisomy 18 and complex cardiac anomalies in the second case proved incompatible with life and treatment was withdrawn. In the final case, an oesophagostomy was fashioned with a gastrostomy for feeding postoperatively and gastric interposition is planned later this year.
极早产儿食管穿孔的管理是一项挑战，且发病率很高。作者报告了他们在过去18个月里遇到的3例极早产新生儿食管穿孔的病例。第一例中，一名原本情况稳定的婴儿被诊断为食管穿孔，经保守治疗后预后良好。在第二例和第三例中，患者在食管穿孔诊断明确之前就进行了开胸手术。第二例随后被诊断为18三体综合征和复杂心脏畸形，证明其与生命不相容，于是停止了治疗。在最后一例中，进行了食管造口术并同时做了胃造口术以便术后喂养，今年晚些时候计划进行胃代食管术。
