Traumatic perforation of the pharynx in the newborn.

Two newborn, low-birth-weight infants with traumatic perforation of the pharynx and an additional 18 previously reported cases are presented. Injury produced by pharyngeal suction catheters and nasogastric and endotracheal tubes is generally unrecognized until the baby develops signs of esophageal obstruction or radiographic evidence of pharyngeal perforation, usually in the posterior mediastinum. The catheter may enter the pericardial space. Conservative management with intravenous antibiotics and a feeding gastrostomy is favored, except in instances that require mediastinal decompression. The key to prevention is the use of soft-tipped suction catheters and nasogastric tubes and careful visualization of the cords during endotracheal intubation. The use of metal stylets to direct the endotracheal tube is condemned. Pediatrics, 56:1019-1022, 1977, PHARYNX, PERFORATION, SUCTION CATHETER, NASOGASTRIC TUBE, ENDOTRACHEAL TUBE, METAL STYLET.