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Conservative management of iatrogenic esophageal perforation during neonatal cardiac surgery

Takashi Sasaki1, Gordon Culham, Sanjiv K Gandhi

  • 1Division of Cardiovascular and Thoracic Surgery, British Columbia Children's Hospital, Vancouver, BC, Canada.

World Journal for Pediatric & Congenital Heart Surgery
|June 28, 2013
PubMed

Insights

Esophageal perforation is a rare but serious complication in children. Transesophageal echocardiography (TEE) can cause esophageal injury, but conservative management can lead to complete resolution, as seen in a neonatal cardiac surgery case.

Area of Science:

  • Pediatric Surgery
  • Cardiology
  • Gastroenterology

Background:

  • Esophageal perforation is a rare, life-threatening condition in children.
  • Iatrogenic causes include nasogastric tube insertion, stricture dilation, and endotracheal intubation.
  • Transesophageal echocardiography (TEE) is increasingly used in pediatric cardiac surgery but its safety is debated due to reported complications like esophageal injury.

Purpose of the Study:

  • To report a rare case of esophageal perforation caused by TEE probe insertion in a neonate undergoing cardiac surgery.
  • To highlight the potential risks associated with TEE in pediatric patients.
  • To demonstrate the efficacy of conservative management for TEE-induced esophageal perforation.

Main Methods:

  • Case report of a neonate experiencing esophageal perforation during cardiac surgery.
  • Description of the diagnostic process and management strategy.
  • Follow-up assessment of the injury resolution.

Main Results:

  • Esophageal perforation occurred during TEE probe insertion in a neonate.
  • The injury was managed conservatively for two weeks.
  • Complete resolution of the esophageal perforation was achieved with conservative management.

Conclusions:

  • Transesophageal echocardiography, while valuable, carries a risk of esophageal perforation in neonates.
  • Conservative management can be effective for TEE-induced esophageal injuries in pediatric patients.
  • This case underscores the importance of vigilance and appropriate management strategies for TEE complications.

Keywords:
conservative managementesophageal perforationneonatal cardiac surgerytransesophageal echocardiography

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