Mollitt D L, Schullinger J N, Santulli T V
J Pediatr Surg. 1981 Dec;16(6):989-93. doi: 10.1016/s0022-3468(81)80861-5.
Since 1974 nine neonates have been treated for iatrogenic esophageal perforation. They ranged in weight from 480 to 3900 g. Four of them had been resuscitated for meconium aspiration, four were being treated for respiratory distress syndrome (RDS), and one had received only routine postpartum suctioning and gastric aspiration. In five infants, esophageal perforation was suspected following traumatic intubation of difficulty in the passage of a catheter or tube. Three neonates passed formula from chest tubes placed for pneumothorax and one child presented with persistent pneumothorax. Esophageal perforation was documented in each case by direct visualization and/or radiographic studies. Three infants were treated with antibiotics and placement of a silastic nasogastric feeding tube. An additional two infants were treated with a silastic tube, antibiotics and chest tube drainage. Four children underwent operation: gastrostomy and drainage (2), gastrostomy and closure of perforation (1), gastrostomy only (1). There were no complications of deaths. Management of iatrogenic perforation of the esophagus depends upon the extent and location of the injury. A nonoperative approach can be successful in those infants with limited injury of short duration. Operation is required in cases with extensive extravasation or delay in diagnosis.
自1974年以来，已有9例新生儿因医源性食管穿孔接受治疗。他们的体重在480至3900克之间。其中4例因胎粪吸入进行了复苏，4例因呼吸窘迫综合征（RDS）接受治疗，1例仅接受了常规产后吸痰和胃抽吸。在5例婴儿中，因插管困难或导管通过困难导致创伤后怀疑食管穿孔。3例新生儿经用于气胸的胸管排出配方奶，1例儿童出现持续性气胸。每例均通过直接观察和/或影像学检查证实食管穿孔。3例婴儿接受了抗生素治疗并放置了硅胶鼻胃饲管。另外2例婴儿接受了硅胶管、抗生素和胸管引流治疗。4例儿童接受了手术：胃造口术和引流（2例）、胃造口术和穿孔闭合术（1例）、仅胃造口术（1例）。无并发症或死亡情况。医源性食管穿孔的处理取决于损伤的程度和部位。对于损伤程度有限且持续时间短的婴儿，非手术方法可能成功。对于有广泛外渗或诊断延迟的病例，则需要手术治疗。
