The Subdiaphragmatic Angle Of The Gastric Tube In Neonates - A Potential Predictor For Perforations?
Klin Padiatr
; 2023 Dec 14.
Article
em En
| MEDLINE
| ID: mdl-38096915
ABSTRACT
BACKGROUND:
Traumatic subdiaphramatic perforation of esophagus or stomach in neonates represents a rare clinical complication following the insertion of a gastric tube and is associated with high morbidity and mortality. The aim of the present study was to evaluate whether the angle of the gastric tube depicted on a plain radiograph may serve as a diagnostic tool to predict subdiaphragmatic traumatic (or iatrogenic) perforation. PATIENTS ANDMETHODS:
Thoraco-abdominal radiographs of 128 preterm and term neonates without perforation and 15 neonates with perforation of the esophagogastric junction or the stomach were retrospectively analysed.RESULTS:
The angle of the gastric tube increases with postnatal age (p=0.0380). In the control group, the angle of the gastric tube varied between 13° and 48° (median 31°), whereas the values ranged from -31° to 42° (median 11°) in neonates with subdiaphragmatic perforation. Perforation should thus be suspected in cases with an angle of<20° (sensitivity 93.3%; specificity 91.4%). Moreover, an unusual localization of the tip beyond the gastric bubble is highly indicative of perforation.DISCUSSION:
The present study emphasizes the importance of verifying the correct course of an inserted gastric tube.CONCLUSIONS:
In daily clinical practice, an angle of<20° should be followed by thorough physical examination, abdominal ultrasound and if applicable contrast medium examinations to exclude perforation.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
Klin Padiatr
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Alemanha