Background: Esophageal perforation is uncommon and often iatrogenic.
Aim: To report a neonatal case of esophageal perforation.
Case: A premature newborn boy was admitted with a diagnosis of oesophageal atresia after several unsuccessful attempts to insert an orogastric tube. A chest x-ray showed a "high pouch" with a gasless intestine. At operation, no atresia was found and a large traumatic perforation of the lower cervical segment was identified, requiring cervicotomy and primary closure. Oral feeding was started after 3 weeks. As a result, nosocomial sepsis occurred, causing death in the third month after surgical treatment.
Conclusion: Oesophageal perforation in the neonate is often iatrogenic and may mimic oesophageal atresia. The authors highlight the importance of early diagnosis and management.