Oesophageal perforation.....What the...??.....

[Linleydearest]

Has anyone seen/ heard of this happening before.

23 week gestation week old infant (400gm), more unstable this particular day. After insertion of peripheral central line - xray performed to confirm line placement and incidently showed the Orogastric tube heading left instead of right into the stomach. Tube had perforated the oesopahgus and entered the pleural space giving the baby a mild pneumothorax. I have never even heard of that happening before.

:uhoh21:

The treatment so far has been - removal of the offending GT, needling the air from the chest, increasing vent presures to splint perforation and generally support babies condition.

And to introduce myself -

Linley aka Linley dearest.

I work in a level 3 (ie no surgery) unit in Sydeny Australia

I have worked in NICU since the completion of my post grad year (1997)

[Gompers, BSN, RN]

I've seen this happen before. With a 23-weeker, I suppose the esophageal tissue is so fragile that it's possible to perforate it with a feeding tube. I've seen babies with stomach perforations as well, but these were more often larger preemies (like 34 weeks) who had the more stiff 8 french tubes in. That's why I never use those personally, even if the baby is term! :uhoh21:

[gypsyatheart]

Welcome to allnurses, Linley. That is an odd happenning, but it makes sense in that the tissue at 23 wks is so fragile like Gompers said.

[t2000JC]

I have heard of this before too! Is there anyway to prevent it? it's scary b/c we do insert OGT/NGTs a lot! t.