Navigation Links
What should we do when esophageal perforation occurs?
Date:3/18/2008

Management of ingested foreign bodies is a common clinical encounter. Complications of this pathology are dependent on a patient's age, the nature and localization of the foreign body, the presence of a perforation, and initial management procedures.

Dr. Christian Righini from the University Medical Center of Grenoble advocates the use of the rigid endoscope which is placed just above the proximal tip of the foreign body where it dilates the esophageal lumen to the extent that the impacted foreign body is movable.

This recommendation is based on Righini's description of a case involving a 52-yr-old man, with no relevant past medical history who presented to the ENT clinic complaining of severe dysphagia, substernal pain, and fever five days after chewing on a piece of chicken. Imaging revealed a fragment of bone in the upper part of esophagus, air in the retropharyngeal space and the upper part of the posterior mediastinum, and deep subcutaneous collection suggestive of cervical posterior mediastinal collection. The patient was managed surgically through both an endoscopic approach and an open cervical approach.

The use of a rigid endoscope during removal of an impacted foreign body has several advantages: it causes expansion of the upper esophagus, which can release totally or in part the impacted foreign body, and prevents aspiration and esophageal or pharyngeal injury. It must be practiced under general anesthesia by a trained operator.

The management of esophageal perforation is dependent on its size and location. Simple suture is recommended in case of small perforation in the cervical esophagus. It is not necessary to use mucosal flaps to reinforce the esophageal sutures, contrarily to the recommendations for injuries of the middle and lower parts of esophagus. In the case of cervical abscess and/or mediastinitis, drainage of the different affected spaces must be carried out.

In conclusion, perforation of the upper esophagus caused by a foreign body is rare, but can cause potentially life threatening mediastinal complications. CT-scanning enables accurate and timely diagnosis and provides valuable indications for treatment. Extraction of the esophageal foreign body with a rigid endoscope is an effective and safe treatment alternative. Non-operative management of esophageal perforation is not an option in the presence of neck and mediastinum abscesses and necessitates a surgical suture and drainage.


'/>"/>

Contact: Jing Zhu
wjg@wjgnet.com
0086-105-908-0039
World Journal of Gastroenterology
Source:Eurekalert

Related medicine news :

1. Mayo Researchers Say ECG Standards Should Be Revised for Elderly
2. Mayo researchers say ECG standards should be revised for elderly
3. First-Time Shoulder Dislocations Helped by Surgery
4. Elbow, Shoulder Injuries Take Heavy Toll on Pro Baseball Players
5. Controversial shoulder surgery for first-time dislocation proven effective long-term
6. Comeback to a Pre-Injury Level After Elbow or Shoulder Surgery Disappointing for Pro Baseball Players
7. Should You Worry About Mercury Poisoning? Find out in the March Issue of Natural Solutions - Now on Newsstands
8. Smith & Nephew Endoscopys BIORAPTOR(TM) 2.3 PK Suture Anchor Provides Secure Repair for Shoulder, Hip Instability
9. That Sex Talk With Your Kids Should Be Ongoing
10. Pain Management For Your Pets, Key Information Every Pet Owner Should Know - Live Webcast to Pet Owners, March 13, 8:00 p.m. to 9:00 p.m. (EDT) Via Morris Animal Foundation
11. Doctors should watch for depression in arthritis patients
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:1/24/2017)... ... 24, 2017 , ... Element Blue ™, a leading ... strategic partnership with Lucidworks , the company transforming the way people access ... for building powerful enterprise search applications. , Element Blue is a global team ...
(Date:1/24/2017)... ... January 24, 2017 , ... i2i Population Health, a national leader ... , “Cary’s broad financial background is an excellent fit for i2i,” ... and day-to-day financial operations skills we need to take the company to the next ...
(Date:1/24/2017)... (PRWEB) , ... January 24, 2017 , ... The ... MSC Cruises as part of the line’s 4th Annual MSC True Partnerships’ Awards. ... performing North American travel partners for the year based on overall business growth in ...
(Date:1/24/2017)... ... January 24, 2017 , ... Twelve startups ... of the 2017 Cupid's Cup Entrepreneurship Competition. Chaired by Under Armour Founder and ... The entrepreneurs will showcase their businesses on February 6, 2017, at Under Armour’s ...
(Date:1/24/2017)... ... January 24, 2017 , ... West’s Health ... annual Solutions Series of webinars will start January 31 with a session about ... of current health and benefits topics, including employee engagement, pricing transparency, population health ...
Breaking Medicine News(10 mins):
(Date:1/24/2017)... India , Jan. 24, 2017 Market Research Future has ... Market for Wound Closure Device is growing rapidly and expected to continue ... ... at a CAGR of 5% from 2013 to 2019 and reaching a ... of the forecasted period, 2016-2022 Global Wound Closure Device Market ...
(Date:1/24/2017)... Nev. , Jan. 24, 2017  The ... that specializes in high-value orthopaedic implants, announced the ... today. The OIC Tibial Nail ... tibia. Strategically placed proximal and distal screw holes ... hole that allows dynamization.  The nail is available ...
(Date:1/24/2017)... 2017 Trifecta Clinical , a leading ... Rick Ward to Vice President of Commercial ... also announcing the promotion of Ericka Atkinson ... Rick joins Trifecta from Greenphire where he was ... business development positions within the healthcare industry throughout his ...
Breaking Medicine Technology: