title: Iatrogenic traumas by nasogastric tube in very premature infants: our cases and literature review.
abstract: OBJECTIVE
  The nasogastric tube is the chosen nutritional technique in premature infants. However, it is not without complications. The aim of this study is to compare our experience in iatrogenic complications caused by nasogastric tube (especially in very low birth weight infants) to a review of the most recent literature.
  
  
  METHODS
  From january to december of 2008, in the Department of Neonatal Pathology at the Hospital of Treviso, 118 premature patients were treated. 110 of them had a body weight less than 1,500gr: serious complications caused by nasogastric tube occurred in two of these very low birth weight infants. The first case relates an injury of the esophagus, while the second case is about a perforation of the posterior wall of the stomach, left lobe of the liver and the spleen hilus.
  
  
  RESULTS
  The surgical treatment was limited to the second case ending in splenectomy and repair of the posterior gastric wall and liver lobe.
  
  
  CONCLUSIONS
  Among all the iatrogenic injuries described in the literature, this last case is the most serious. It is important to verify always the position of the gastric tube and to doubt for a dislocation in any case of deviation of the tube from the normal course. In those cases in which a patient suddenly goes from a full well-being to a critical state without a precise contingent cause it is imperative to check the nasogastric tube place. In addition those cases have guided us to change our habits for managing these critical patients: we are then oriented toward the usage of silastic gastric probes, which are softer, less dangerous for ulcer damages, and long term replaceable, thus reducing the possibility of a iatrogenic injury.
authors: Department of Pediatric Surgery, Department of Pediatrics, Treviso, Italy. marco.gasparella@unipd.it
authors: M
authors: M
authors: Gasparella
authors: G
authors: G
authors: Schiavon
authors: L
authors: L
authors: Bordignon
authors: M
authors: M
authors: Buffo
authors: C
authors: C
authors: Benetton
authors: C
authors: C
authors: Zanatta
authors: M
authors: M
authors: Ferro
authors: F
authors: F
authors: Zoppellaro
authors: G
authors: G
authors: Perrino
mesh_terms: D041981:Gastrointestinal Tract / Q000293:injuries; D006801:Humans; D007049:Iatrogenic Disease; D007231:Infant, Newborn; D007234:Infant, Premature; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D008297:Male