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At least 1,711 records · Page 95Linked to original sources
PubMed2002

Fatal Hemorrhage following perforation of the aorta by a barb of the Gianturco-Rösch esophageal stent.

Self-expanding metal stents are an established option in the palliative treatment of malignant stenoses of the esophagus. Herein, we report on a 60-year-old man with a recurrent stenosis that developed 2 months after radiochemotherapy for a squamous cell carcinoma in the middle part of the esophagus. To relieve progressive dysphagia, a Gianturco-Rösch stent (Cook-Z stent, 10 cm, PE-covered, manufactured by William Cook Europe) was implanted. Six weeks later, precipitous massive hemoptysis leading to the collapse and death of the patient occurred. Autopsy showed that a barb in the middle of the stent had perforated the aortic arch, resulting in massive bleeding into the gastrointestinal tract, and aspiration. Although hemorrhage and esophageal perforation are known late complications of all types of metal stents, our case is the first description of a perforation involving a fixation barb. These barbs are a particular feature of the European version of the Cook-Z stent, and are intended to prevent stent migration. In future, any hemorrhage observed after stent implantation should prompt a search for perforation by a barb (autopsy!). If necessary, the European version of the Gianturco Z stent should be modified.

Aorta, Thoracic↗
PubMed2005

Use of polyvinyl feeding tubes and iatrogenic pharyngo-oesophageal perforation in very-low-birthweight infants.

BACKGROUND: Placement of a feeding tube may be associated with various complications, including iatrogenic pharyngo-oesophageal perforation. AIM: To determine the incidence of pharyngo-oesophageal perforation secondary to the use of polyvinyl feeding tubes in newborns weighing less than 1500 g, we conducted a retrospective study over a 3(1/2)-y period. METHODS: All the hospital files of the 371 very-low-birthweight newborns admitted were retrospectively reviewed. RESULTS: Three iatrogenic pharyngo-oesophageal perforations were observed, giving an incidence of 1:124 preterm infants. This incidence reaches values of 1:25 newborns weighing less than 750 g. Data from our cases included clinical presentation and outcome, radiological evaluation, and type of feeding tube. One infant died of sepsis, and the clinical course was compatible with mediastinitis. The other two infants were treated successfully with conservative non-surgical management. CONCLUSION: Pharyngo-oesophageal perforation in our experience exclusively involved preterm infants weighing less than 750 g after traumatic placement of a polyvinyl feeding tube. The use of a silastic feeding tube with a really soft end instead of polyvinyl catheters could probably avoid iatrogenic oesophageal perforation.

Enteral Nutrition↗
PubMed2006

Sword swallowing and its side effects.

OBJECTIVE: To evaluate information on the practice and associated ill effects of sword swallowing. DESIGN: Letters sent to sword swallowers requesting information on technique and complications. SETTING: Membership lists of the Sword Swallowers' Association International. PARTICIPANTS: 110 sword swallowers from 16 countries. RESULTS: We had information from 46 sword swallowers. Major complications are more likely when the swallower is distracted or swallows multiple or unusual swords or when previous injury is present. Perforations mainly involve the oesophagus and usually have a good prognosis. Sore throats are common, particularly while the skill is being learnt or when performances are too frequent. Major gastrointestinal bleeding sometimes occurs, and occasional chest pains tend to be treated without medical advice. Sword swallowers without healthcare coverage expose themselves to financial as well as physical risk. CONCLUSIONS: Sword swallowers run a higher risk of injury when they are distracted or adding embellishments to their performance, but injured performers have a better prognosis than patients who suffer iatrogenic perforation.

Adolescent↗
PubMed1983

Pharyngoesophageal perforations after blunt trauma to the neck.

The neck with cartilaginous framework left intact still requires a high index of suspicion of a pharyngoesophageal perforation after blunt trauma. If the diagnosis is missed and/or prompt surgical drainage of the perforation is delayed, increased morbidity from deep neck abscesses and/or death may result. This is the first reported series of pharyngoesophageal perforations that follow blunt trauma. On the basis of this clinical experience and the literature, I have formulated a treatment protocol for upper aerodigestive tract perforations secondary to blunt trauma.

Adult↗
PubMed1990

Moss nasogastric tube and treatment of a perforated esophagus.

Nonoperative treatment of perforation of the esophagus can have a successful outcome. In conjunction with other modalities, the Moss nasogastric tube most closely simulates benefits obtained by direct surgical intervention upon the perforated esophagus.

Esophageal Perforation↗
PubMed1975

The columnar epithelial-lined lower esophagus and its association with adenocarcinoma of the esophagus.

Four cases of columnar epithelial-lined lower esophagus are presented. The condition can be complicated by esophagitis, ulceration, perforation, and adenocarcinoma of the esophagus. When the squamocolumnar junction is involved by peptic esophagitis, the area of mucosal transition appears as a tapered, strictured segment or a ring-line constriction some distance proximal to the muscular esophagogastric junction. Hiatal incompetence with massive gastroesophageal reflux was evident in 1 case. A deep penetrating ulcer may occur anywhere along the columnar epithelium, identical to peptic gastric ulceration. The columnar-lined lower esophagus should probably be considered a premalignant condition. Two of these patients had associated esophageal adenocarcinoma.

Adenocarcinoma↗