A neonate may develop a traumatic pharyngeal perforation following a medical intervention.
Preceding event:
(1) during placement of nasogastric or endotracheal tube
(2) use of pharyngeal suction catheter
Notes in the medical record may indicate that:
(1) The person inserting the tube or catheter may notice difficulty placing the tube.
(2) There was emergency placement of the endotracheal tube.
Signs and symptoms may mimic esophageal atresia:
(1) respiratory distress
(2) increased salivation with drooling
(3) feeding problems
(4) cervical emphysema
(5) coughing and choking
Imaging studies may show:
(1) pneumothorax
(2) pleural effusion
(3) pneumomediastinum
(4) ectopic location of a feeding tube
(5) pseudo-diverticulum
Complications:
(1) mediastinitis
(2) mediastinal mass formation
(3) sepsis
(4) stricture
The condition can often be managed medically unless there are mediastinal complications.
