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[Traumatic pseudodiverticulum of the esophagus. Description of a case in a preterm newborn infant]
M Gorinati1, A Dodero, V Semini
1Sez. di Patologia Neonatale, Divisione Pediatrica Ospedale Civile, Conegliano, Italia.
Insights
A traumatic esophageal pseudodiverticulum in a very low birth weight (VLBW) preterm infant was successfully managed with medical therapy. This case highlights the importance of considering traumatic perforation as a cause of esophageal obstruction in neonates.
Area of Science:
- Neonatal Medicine
- Pediatric Surgery
- Gastroenterology
Background:
- Esophageal atresia is a congenital anomaly that can present with signs of obstruction in neonates.
- Traumatic esophageal injuries are rare in preterm infants but can mimic congenital anomalies.
- Very low birth weight (VLBW) infants often have complex medical conditions requiring careful management.
Observation:
- A VLBW preterm infant presented with clinical and radiological findings suggestive of esophageal atresia.
- Initial management included broad-spectrum antibiotics and total parenteral nutrition due to prematurity and respiratory distress syndrome (RDS).
- Passage of orogastric tubes was performed after initial stabilization.
Findings:
- A second esophagography revealed a normally canalized esophagus, indicating the absence of atresia.
- The findings suggest a traumatic esophageal pseudodiverticulum as the cause of the apparent obstruction.
- The infant's condition improved with conservative medical management.
Implications:
- Traumatic esophageal perforation should be considered in the differential diagnosis of neonatal esophageal obstruction.
- Conservative medical management, including antibiotics and nutritional support, can be effective for traumatic esophageal pseudodiverticulum.
- This case underscores the importance of a thorough diagnostic approach in complex neonatal cases.
Abstract:
A case of traumatic oesophageal pseudodiverticulum in a VLBW preterm infant is reported. Both clinical and radiological findings were suggestive for oesophageal atresia. A medical therapeutic approach, including the use of wide spectrum antibiotics and a regimen of total parenteral nutrition, was initially chosen for her highly premature status and bad clinical conditions (RDS). Nineteen days after birth the passage of orogastric tubes led to a second esophagography that showed a normally canalized oesophagus. The importance of considering the traumatic perforation among the causes of oesophageal obstruction in the neonatal period is stressed along with the safety and effectiveness of its simply medical management.