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PubMedDate not supplied

[Iatrogenic esophageal perforation-- severe complication in the care of premature infants].

Two preterm neonates were referred to our institution, one with suspected oesophageal atresia and one with the definite diagnosis of oesophageal atresia for further treatment. Diagnostic procedures identified an iatrogenic perforation of the oesophagus which was caused by a feeding tube in both patients. The treatment was based on broad-spectrum antibiotic therapy and parenteral nutrition. The perforations healed without long term sequelae.

Anti-Bacterial Agents↗
PubMed1999

Esophageal perforation and mediastinal abscess following placement of a covered self-expanding metallic stent and radiation therapy in a cancer patient.

Patients with advanced esophageal cancer may require intubation with a stent to relieve debilitating dysphagia. However, if these patients also undergo radiation therapy, they may incur esophageal injury, thus increasing the risk of perforation after placement of the stent. Herein we report the case of a 71-year-old man who received such combination therapy and died of severe sepsis 65 days after the stent was inserted. An autopsy revealed that the stent had perforated into the mediastinal pleura and that an abscess had developed around the perforation. We conclude that caution should be taken before combining radiation therapy with the use of a stent.

Abscess↗
PubMed1991

[Esophageal perforation and pneumothorax. Complications due to placement of a stomach tube].

Perforation of the oesophagus, as well as a pneumothorax are described as complications of the use of a nasogastric feeding tube. Clinical tests to determine correct placement are noted to be unreliable and the importance of radiological control, especially in the unconscious patient, ist stressed. The suspected diagnosis of oesophageal perforation should be verified without delay to immediately initiate conservative or surgical treatment.

Adult↗
PubMed1995

Endoscopic clipping of esophageal perforation after pneumatic dilation for achalasia.

A 67-year-old man with a long history of achalasia underwent pneumatic dilation of the lower esophageal sphincter due to increasing dysphagia. During the procedure, a small perforation of the thoracic part of the distal esophagus occurred. Since the rupture was small, well-confined, and detected immediately, the lesion was closed using endoscopically applied metallic clips. The patient did very well, and a contrast swallow three days later showed no leakage of the esophagus. This procedure has not yet been described for the esophagus in the literature, but it may be considered in selected cases of small and well-defined instrumental perforations.

Aged↗
PubMed1994

[Esophageal perforations].

The opportunity of having successfully treated a patient with intrathoracic perforation of the Oesophagus and many surgical complications, led us to review the literature on the subject. We then discussed the advantages and disadvantages of the various technical options, concluding that immediate Oesophagectomy is the best solution for this type of perforation, with several hours of evolution and serious mediastinite, to reduce surgical complications and mortality.

Esophageal Perforation↗
PubMed1995

[Surgical treatment of life-threatening mediastinitis following esophageal perforation or leakage after esophagus surgery].

OBJECTIVE: Evaluation of the surgical treatment of life-threatening mediastinitis following oesophageal perforation or leakage after resection for oesophageal cancer. DESIGN: Descriptive retrospective. SETTING: Department of Surgery, University Hospital Utrecht. METHODS: Between June 1989 and October 1994, 18 patients with severe mediastinitis and sepsis following perforation of the oesophagus or leakage after oesophageal resection for oesophageal cancer were treated with aggressive surgery. (Peri-)anastomotic leakage was the cause of mediastinitis and sepsis in 14 patients, 3 patients perforated during endoscopy and 1 patient suffered a spontaneous perforation. Aggressive surgery consisted of removing the oesophageal replacement from the mediastinum, creating an oesophago-cutaneostomy and a feeding enterostomy and drainage of the mediastinum and interpleural spaces. RESULTS: All patients survived; however, postoperative morbidity was high. The alimentary tract was reconstructed in 15 patients. CONCLUSION: Aggressive surgical treatment of life-threatening mediastinitis and sepsis as described here can save severely ill patients. Because of the high postoperative morbidity level only patients with perforations of the oesophagus and early stages of oesophageal cancer should be operated.

Adult↗