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Latrogenic complications due to the nasogastric and rectal cannula in neonates
Anna Tarnowska1, Krystyna Potocka, Andrzej Marciński
1Department of Pediatric Radiology, The Medical University of Warsaw, Warsaw, Poland. annatarno@wp.pl
Insights
Nasogastric tube malposition can cause serious iatrogenic injuries in neonates. Plain X-rays are crucial for detecting tube displacement and preventing alimentary tract perforation, even without other symptoms.
Area of Science:
- Neonatal care
- Pediatric surgery
- Radiology
Background:
- Iatrogenic injuries from abnormal nasogastric (NG) and rectal tube placement are a significant concern in neonates.
- Premature infants are particularly vulnerable to these complications.
Observation:
- A study observed 9 neonates (8 premature) with alimentary tract perforation between 1982 and 2003.
- Nasogastric tube displacement was the primary radiological sign in most cases.
Findings:
- Esophageal perforation occurred in 5 neonates, gastric perforation in 3, and rectal cannula perforation in 1.
- Conservative treatment was effective for esophageal perforations; however, surgical intervention for gastric and rectal perforations had a 50% mortality rate.
Implications:
- Plain chest and abdominal X-rays are vital for evaluating nasogastric tube position.
- Any deviation from the normal tube course should raise suspicion for alimentary tract injury, even if other signs of perforation are absent.
Background:
An abnormal position of nasogastric and rectal tubes can be the cause of iatrogenic injuries Most often it can happen in neonates and premature infants.
Material/Methods:
From 1982 through 2003, we observed 9 neonates (8 premature infants) with perforation of the alimentary tract.
Results:
In most of these patients the only radiological sign was displacement of the nasogastric tube. In 5 children the tube was outside the esophagus, in 3 outside the stomach, and in 1 case perforation was caused by the rectal cannula. Neonates with esophageal perforation were treated conservatively with good effects. Surgical treatment was performed in four children with gastric and rectal perforation - two of whom died.
Conclusions:
Evaluation of the position of nasogastric tube on the plain chest and abdominal x-ray is a very important diagnostic Consideration. Any deviation from the normal course of the tube should be suggestive of alimentary tract injury, even in the absence of any other signs of perforation.
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