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Duodenal perforation caused by a transpyloric tube in a critically ill infant

Jose C Flores1, Jesús López-Herce, Itziar Sola

  • 1Sección de Cuidados Intensivos Pediátricos, Hospital Gregorio Marañón, Madrid, Spain.

Nutrition (Burbank, Los Angeles County, Calif.)
|February 7, 2006
PubMed

Insights

A transpyloric tube caused a duodenal perforation in a 2-month-old infant, leading to fatal complications. This case highlights the critical need for accurate tube placement confirmation to prevent intestinal injury.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Neonatal Intensive Care

Background:

  • Transpyloric tubes are used for enteral feeding in infants.
  • Accurate placement is crucial to prevent gastrointestinal complications.

Observation:

  • A 2-month-old infant on mechanical ventilation developed a duodenal perforation from a 6-Fr polyurethane transpyloric tube.
  • Initial abdominal ultrasound incorrectly suggested correct tube placement.

Findings:

  • The mispositioned tube led to enteral nutrition administration into the intestinal lumen, causing severe peritonitis.
  • Laparotomy revealed duodenal perforation; subsequent perforations and progressive intestinal damage resulted in multiorgan failure and death.

Implications:

  • Clinical suspicion of transpyloric tube-related perforation necessitates immediate radiographic and echographic confirmation.
  • In cases of doubt, tube withdrawal followed by endoscopic or contrast radiography is essential to prevent catastrophic outcomes.
Abstract

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