{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T10:35:19Z","timestamp":1772102119357,"version":"3.50.1"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Padiatr"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n               Background Traumatic subdiaphramatic perforation of esophagus or stomach\n                    in neonates represents a rare clinical complication following the insertion of a\n                    gastric tube and is associated with high morbidity and mortality. The aim of the\n                    present study was to evaluate whether the angle of the gastric tube depicted on\n                    a plain radiograph may serve as a diagnostic tool to predict subdiaphragmatic\n                    traumatic (or iatrogenic) perforation.<\/jats:p><jats:p>\n               Patients and methods Thoraco-abdominal radiographs of 128 preterm and term\n                    neonates without perforation and 15 neonates with perforation of the\n                    esophagogastric junction or the stomach were retrospectively analysed.<\/jats:p><jats:p>\n               Results The angle of the gastric tube increases with postnatal age\n                    (p=0.0380). In the control group, the angle of the gastric tube varied\n                    between 13\u00b0 and 48\u00b0 (median: 31\u00b0), whereas the values\n                    ranged from -31\u00b0 to 42\u00b0 (median: 11\u00b0) in neonates with\n                    subdiaphragmatic perforation. Perforation should thus be suspected in cases with\n                    an angle of&lt;20\u00b0 (sensitivity: 93.3%; specificity:\n                    91.4%). Moreover, an unusual localization of the tip beyond the gastric\n                    bubble is highly indicative of perforation.<\/jats:p><jats:p>\n               Discussion The present study emphasizes the importance of verifying the\n                    correct course of an inserted gastric tube.<\/jats:p><jats:p>\n               Conclusions In daily clinical practice, an angle of&lt;20\u00b0\n                    should be followed by thorough physical examination, abdominal ultrasound and if\n                    applicable contrast medium examinations to exclude perforation.<\/jats:p>","DOI":"10.1055\/a-2187-5404","type":"journal-article","created":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T19:14:27Z","timestamp":1702581267000},"page":"259-265","source":"Crossref","is-referenced-by-count":2,"title":["The Subdiaphragmatic Angle Of The Gastric Tube In Neonates \u2013\n                    A Potential Predictor For Perforations?"],"prefix":"10.1055","volume":"237","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8864-3240","authenticated-orcid":false,"given":"Sonja","family":"Diez","sequence":"additional","affiliation":[{"name":"Pediatric Surgery, Erlangen University Hospital, Erlangen,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilda","family":"Bartos","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University of\n                    Marburg, Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Siemes","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Medicine, Christophorus Group,\n                    Coesfeld, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hubert","family":"Gerleve","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Medicine, Christophorus Group,\n                    Coesfeld, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Schock","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Pediatric Urology, University of\n                    Marburg, Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Besend\u00f6rfer","sequence":"additional","affiliation":[{"name":"Pediatric Surgery, Erlangen University Hospital, Erlangen,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas H.","family":"Mahnken","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University of\n                    Marburg, Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christel","family":"Wei\u00df","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics and Biomathematics, Heidelberg\n                    University, Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ursula","family":"Felderhoff-M\u00fcser","sequence":"additional","affiliation":[{"name":"Department of Pediatrics I, Neonatology, University Hospital Essen,\n                    University Duisburg-Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanna","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Neonatology and Pediatric Intensive Care, Department of Pediatrics,\n                    University of Marburg, Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,12,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"151","DOI":"10.4240\/wjgs.v6.i8.151","article-title":"Neonatal gastric perforation: A single center experience","volume":"6","author":"J Byun","year":"2014","journal-title":"World 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Avoiding gastric perforation from feeding tubes in\n                    neonates","volume":"62","author":"A Sinnathamby","year":"2021","journal-title":"Pediatr Neonatol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1016\/j.pedneo.2019.01.008","article-title":"Neonatal gastric perforation enclosed by the lesser sac","volume":"60","author":"H Ichiba","year":"2019","journal-title":"Pediatr Neonatol"},{"key":"ref14","first-page":"1038","article-title":"Pneumo-omentocele - a Sign of Silent Lethal Neonatal Posterior Gastric\n                    Perforation","volume":"1","author":"DRP R Govani","year":"2014","journal-title":"Austin J Clin Case Rep"},{"key":"ref15","first-page":"1009","article-title":"Gastric perforation in two neonates: Spontaneous? Secondary to feeding tube: A\n                    case report","volume":"2","author":"SPA G Prashant","year":"2016","journal-title":"SM J Pediatr Surg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1278","DOI":"10.1016\/j.jpedsurg.2015.04.007","article-title":"Prognostic factors and concomitant anomalies in neonatal gastric\n                    perforation","volume":"50","author":"C-Y Yang","year":"2015","journal-title":"J Pediatr Surg"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1007\/s00247-019-04611-1","article-title":"Intracavitary contrast-enhanced ultrasonography in children: review with\n                    procedural recommendations and clinical applications from the European Society\n                    of Paediatric Radiology abdominal imaging task force","volume":"50","author":"D Klju\u010dev\u0161ek","year":"2020","journal-title":"Pediatr Radiol"}],"container-title":["Klinische P\u00e4diatrie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2187-5404.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T22:37:36Z","timestamp":1757111856000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2187-5404"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,14]]},"references-count":16,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2025,9,5]]},"published-print":{"date-parts":[[2025,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2187-5404","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0300-8630","1439-3824"],"issn-type":[{"value":"0300-8630","type":"print"},{"value":"1439-3824","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,14]]}}}