TY - JOUR T1 - Misplaced gastric tube: a case of oesophageal perforation in a preterm neonate JF - Archives of disease in childhood - Education & practice edition JO - Arch Dis Child Educ Pract Ed SP - 198 LP - 199 DO - 10.1136/archdischild-2022-323828 VL - 108 IS - 3 AU - Claire L Granger AU - Charlotte Ashton AU - Robert Tinnion Y1 - 2023/06/01 UR - http://ep.bmj.com/content/108/3/198.abstract N2 - A 25-week infant, born in a level one unit, was intubated, ventilated and transferred to the tertiary neonatal centre without incident. He had acute respiratory collapse on day 2 with a right-sided tension pneumothorax (figure 1A), which was drained. He remained stable until day 7 when he deteriorated, with increased oxygen requirement and poor feed tolerance (figure 1B). On review, there were gastric tube aspirates over the preceding days with high pH (>6–8), consisting mainly of large volumes of undigested milk.Figure 1 X-rays on (A) day 2 and (B) day 7.What do these radiographs show?What is your differential diagnosis?What would your concerns be?How would you manage this? Answers can be found on page 2. AnswersThe first image shows a right-sided tension pneumothorax. The gastric tube tip projects … ER -