新生児食道穿孔の1治験例

抄録

Iatrogenic esophageal perforation in a newborn may happen during intensive care of prematures. Its clinical and roentogenographic findings resemble those of esophageal atresia or double esophagus. One case of traumatic pharyngoesophageal pseudodiverticulum in a low-birth-weight newborn was presented in this paper. A Japanese female infant was born weighing 1600g at 38-week gestation. Soon after delivery, she was transferred to our hospital because of dyspnea and cyanosis. We unsuccessfully attempted to pass a catheter into the stomach. In contrast X-ray examinations carried out with isotonic water soluble contrast material through a catheter was demonstrated a pseudodiverticulum. The lesion extended to the level of the diaphragm in the posterior mediastinum. A diagnosis of accidental esophageal perforation was made. It was caused by oropharyngeal suction at birth. She was treated successfully with antibiotics and gastrostomy. Since esophageal perforation in a newborn was first reported by Eklof in 1968, 90 cases have been reported in literatures. Therapy should be selected and based upon not only the type and extent of injury, but the underlying condition of an infant