Esophageal perforation due to endoscopic retrograde cholangiopancreatography.
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We presented a case of neonatal hypopharyngeal perforation resulting from extraction of a breech presentation, with symptoms of regurgitation at all feedings and excessive salivation. Inability to pass a nasogastric tube suggested the diagnosis of esophageal atresia. The diagnosis and treatment of this condition is discussed, and the literature is reviewed.
Known for its reliability, transoesophageal echocardiography is an investigation which is increasingly used in cardiology, cardiac surgery and intensive care units. It is a semi-invasive investigation of which oesophageal perforation is a very rare but serious complication. Two cases of oesophageal perforation after transoesophageal echocardiography are reported out of a series of 87 oesophageal perforations treated between January 1981 and February 1999. In both cases, transoesophageal echocardiography was performed in conscious patients without known pre-existing oesophageal pathology. The presentations were acute. Both patients underwent emergency surgery. One patient is alive and the other one died one month after a second operation related to the perforation. Nine cases of oesophageal perforation have been reported after transoesophageal echocardiography. The pathogenesis, means of prevention and treatment of oesophageal perforation are discussed.
A total of 213 patients with a foreign body in the oesophagus was treated in our unit between 1980-1990. Most of the foreign bodies were impacted in the cervical oesophagus. Oesophagoscopy were carried out under general anaesthesia in all cases. iatrogenic perforation of oesophagus was encountered in ten cases. Our results suggest that most instrumental perforation of the esophagus should be managed surgically. Drainage and closure of cervical perforations yields good results. Nonoperative management night be entertained in minimally symptomatic patients harboring a late, locally contained perforation without signs of ongoing sepsis.
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