[A case report of esophageal perforation (author's transl)].
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A 16-month-old infant ingested an alkaline battery, 22 mm x 5 mm, which became entrapped in her esophagus. She was brought to the emergency department with a four-day history of vomiting. After tube thoracostomy, the battery was removed by esophagoscopy. However, she experienced cardiac arrest in the intensive care unit. Post mortem examination revealed exsanguination by perforation of the posterior aspect of the aortic arch as the cause of death. Microscopic examination showed liquefaction necrosis through the mucosa and submucosa of the esophagus into the upper mediastinum and right pleural space. The possible role of the alkaline center of the battery causing perforation is presented.
A case is presented of a 2,5-year-old child in whom high oesophageal perforation developed after gastric lavage due to ingestion of lethal dose of salicylates. Strong, locally irritating action of salicylates on the oesophageal mucosa was demonstrated which, most probably, was the cause of the perforation.
Three patients with a history of anterior spinal surgery treated with a polymethylmethacrylate construct had extrusion of their constructs. In two instances, there were life-threatening esophageal fistulas, mediastinitis, and sepsis 3 months to 10 years after the original surgery. Surgical treatment required removal of the construct, treatment of the esophageal injury, and use of new spinal stabilization. Based on their experience and a review of the literature, the authors strongly recommend against the use of polymethylmethacrylate alone in anterior procedures involving the cervical spine except to treat malignancies in patients with a short life expectancy.
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