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:6/24/2016)... , ... June 24, 2016 , ... Topical BioMedics, Inc, makers of Topricin and MyPainAway ... call for a minimum wage raise to $12 an hour by 2020 and then adjusting ... restore the lost value of the minimum wage, assure the wage floor does not erode ...
(Date:6/24/2016)... ... June 24, 2016 , ... EB ... Decision Making in Emergency Medicine conference in Ponte Vedra Beach, FL. The awards ... in Emergency Medicine Practice and Pediatric Emergency Medicine Practice. , “With ...
(Date:6/24/2016)... Las Vegas, Nevada (PRWEB) , ... June 24, ... ... their Las Vegas client, The Grove Investment Group (TGIG), has initiated cultivation and ... The Grove, in Las Vegas and Pahrump, Nevada. , Puradigm is the manufacturer ...
(Date:6/24/2016)... ... June 24, 2016 , ... National recruitment firm ... sciences executive with extensive sequencing and genomics experience, as Vice President of North American ... Hill will be responsible for leading the sales team in the commercialization of the ...
(Date:6/24/2016)... ... 24, 2016 , ... Today, MTI-GlobalStem, a provider of optimized ... difficult to transfect cells, announces its launch of the PluriQ™ G9™ Gene Editing ... is a complete system for culturing and transfecting human pluripotent stem cells ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)...  Astellas today announced the establishment of Astellas Farma Colombia (AFC), a new affiliate with operations headquartered in ... . ... ... ... Astellas ...
(Date:6/23/2016)... -- Guerbet announced today that it has been named a ... One of 12 suppliers to receive the ... of Premier members through exceptional local customer service and ... lower costs. "We ... customer service from Premier," says Massimo Carrara , ...
(Date:6/23/2016)... , June 23, 2016 ... "Surgical Procedure Volumes: Global Analysis (United States, China, ... Canada)" report to their offering. ... essential tool for healthcare business planners, provides surgical procedure ... at surgery trends with an in-depth analysis of growth ...
Breaking Medicine Technology: