Infant Journal
Browse articlesOesophageal perforation masquerading as oesophageal atresia and tracheoesophageal fistula in a very preterm infant
This article reports a case of a preterm baby born at 28+6 weeks’ gestation with moderate to severe respiratory distress syndrome who, on initial chest radiograph, had evidence to suggest a diagnosis of oesophageal atresia and a distal tracheoesophageal fistula. He subsequently underwent a thoracotomy where this diagnosis was refuted and instead, the diagnosis of oesophageal perforation was made. We review the subtle clues that may have indicated oesophageal perforation and prevented the transfer to the surgical centre and subsequent thoracotomy.
Madhusudan Guin
Neonatal Registrar, William Harvey Hospital, Ashford, Kent
m.guin@nhs.net
Iain Yardley
Consultant Paediatric and Neonatal Surgeon, Guy's and St Thomas' NHS Foundation Trust, London
Vimal Vasu
Consultant Neonatologist, William Harvey Hospital, Ashford, Kent
Guin M., Yardley I., Vasu V. Oesophageal perforation masquerading as oesophageal atresia and tracheoesophageal fistula in a very preterm infant. Infant 2023; 19(2): 51-53.
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- Failure to pass an orogastric tube may not necessarily indicate oesophageal atresia.
- Oesophageal perforation should be considered where repeated intubation attempts are followed by difficulty in passing a nasogastric tube.
- High index of suspicion and a preoperative contrast study or intraoperative bronchoscopy would have avoided thoracotomy.
