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:10/13/2017)... WI (PRWEB) , ... October 13, 2017 , ... As ... in medicine known as “patient engagement.” The patient is doing more than filling out ... partners. , “There is an increasing emphasis in health care and research on ...
(Date:10/13/2017)... ... October 13, 2017 , ... The American Board of Family Medicine's ... President and Chief Executive Officer, succeeding Dr. James C. Puffer upon his retirement. Dr. ... 2018 until Dr. Puffer’s retirement at the end of 2018. Upon assuming the role ...
(Date:10/13/2017)... Las Vegas, Nevada (PRWEB) , ... October 13, 2017 , ... ... of 7® Hemp CBD Oil utilizing Purzorb™ technology. Applying the Purzorb™process to full spectrum ... CBD dose required and providing a CBD form that can be easily incorporated into ...
(Date:10/13/2017)... ... October 13, 2017 , ... Lori R. Somekh, founder of the ... a national organization of elder law and special needs planning attorneys. “Membership in ElderCounsel ... also provides a forum to network with elder law attorneys nationwide,” said Somekh. ...
(Date:10/13/2017)... ... October 13, 2017 , ... Many families have long-term insurance that ... insurance companies have a waiver for care if the client has a cognitive impairment ... family pays for care, is often waived, so the benefits from their insurance start ...
Breaking Medicine News(10 mins):
(Date:10/11/2017)... PARK, Calif. , Oct. 11, 2017  BioPharmX ... national scientific team that developed an innovative way to ... quantity of the delivery of new drugs. ... 2017 Fall Clinical Dermatology Conference will show how researchers ... General Hospital, Harvard Medical School used a suite of ...
(Date:10/11/2017)... Oct. 11, 2017  True Health, a leader ... its effort during National Breast Cancer Awareness month ... risks. Research ... calculated that more than 10 million American women ... in BRCA1 or BRCA2 and have not had testing. ...
(Date:10/10/2017)... , Oct. 10, 2017  NDS received FDA 510(k) clearance in ... medical-grade battery-powered display stand specifically designed for endoscopy environments. An innovative ... into a clinical solution to support the improvement of patient outcomes, ... Design ... Solution ...
Breaking Medicine Technology: