Ann Pediatr Res | Volume 8, Issue 1 | Research Article | Open Access
Kan SY*, Ngeow AJH, Tan MG, Jacobsen AS, Sanamandra SK and Poon WB
1Department of Neonatal & Developmental Medicine, Singapore General Hospital, Singapore 2Department of Pediatric Surgery, KK Women and Children’s Hospital, Singapore 3Department of Diagnostic Radiology, Singapore General Hospital, Singapore
*Correspondance to: Kan Sheau Yun
Fulltext PDFObjective: The purpose of our study was to summarize the clinical course of neonates with Esophageal Perforation (OP), and identify potential risk factors. Methods: Retrospective case-control study of neonates with OP between 2005 and 2020 at a Singapore tertiary neonatal unit. Four controls per case were matched by gestational age and month of birth. Data on baseline characteristics, morbidity, mortality, time to attain full feeds, and hospitalization duration, was collected. Results: The incidence of OP was 4.5 per 10,000 livebirths. 12 cases of OP and 48 matched controls were included. All OP patients had Very Low Birth Weight (VLBW) with mean birthweight of 729.8 g and median gestational age of 26 weeks. Median Apgar scores were 6 and 8 for OP at 1- and 5-min. OP cases were more likely to be male (OR 1.51, p<0.01), and associated with maternal pre-eclampsia (OR 5.3, p<0.05). Most (n=7, 58%) presented on day of birth. The commonest presentation was air-leak (n=10, 83.3%). All OP cases required intubation (OR 2.00, p<0.01), and history of difficult intubation was noted in 4 cases. All OP patients were managed conservatively. The average duration of hospitalization was 91 days. OP was associated with necrotizing enterocolitis (OR 5.4, p<0.05). There was no difference in mortality. Conclusion: VLBW neonates are at risk of OP. Preventive measures, prompt recognition, and conservative treatment have been shown in our experience to be successful in achieving resolution of OP, in the absence of concomitant risk factors of mediastinitis, and/or persistent air leaks.
Esophageal perforation; VLBW; NICU; OP
Kan SY, Ngeow AJH, Tan MG, Jacobsen AS, Sanamandra SK, Poon WB. Esophageal Perforation in VLBW Infants in a Singapore Tertiary Hospital: A Case-Control Study. Ann Pediatr Res. 2024; 8(1): 1081..