Acute Mediastinitis Associated with Foreign Body Erosion from the Hypopharynx and Esophagus

Li, Jiajia; Zhang, Xiaoli; Xie, Dong; Peng, Anquan; Yang, Xinming; Yu, Fenglei; Liu, Deliang

doi:10.1177/0194599811425140

Cited by 15 publications

(8 citation statements)

References 14 publications

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“…Computed tomography (CT) is much more sensitive in the detection of any kind of foreign bodies prior to endoscopic interventions than plain radiographies. Importantly, the role of CT scan is not only to localize esophageal foreign bodies but also to evaluate relevant regional complications such as perforation, fistulization, and even pleural empyema [ 22 ]. Zhu et al reported that a more advanced dual source CT can even elevate the sensitivity and specificity to near 100% of diagnosis and evaluation of esophageal foreign bodies violently [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract of Adults

Yao

et al. 2015

BioMed Research International

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Background. Foreign object ingestion and food bolus impaction are a common clinical problem. We report our clinical experiences in endoscopic management for adults, foreign body ingestion, and food bolus impaction. Method. A retrospective chart review study was conducted on adult patients with foreign body ingestion and food bolus impaction between January 2011 and November 2014. Patients with incomplete medical records were excluded. Results. A total of 198 patients (226 incidents) were included in the study (male/female: 1.54/1; age 57 ± 16 years). Among them, 168 foreign bodies were found successfully (74.3%). 75.6% of the foreign bodies were located in the esophagus. Food bolus impaction was most common (41.6%). 93.5% of foreign bodies in current study cohort were successfully extracted and 5 patients required surgical interventions. Comparisons between symptomatic and asymptomatic patients revealed that locations of foreign bodies in the pharynx and esophagus were the significant relevant factors (P < 0.001). Shorter time taken to initiate endoscopic interventions increased detection rate (289.75 ± 465.94 versus 471.06 ± 659.93 minutes, P = 0.028). Conclusion. Endoscopic management is a safe and highly effective procedure in extracting foreign body ingestion and food bolus impaction. Prompt endoscopic interventions can increase the chance of successful foreign bodies' detection.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract of Adults

Yao

et al. 2015

BioMed Research International

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“…[4] The role of CT scanning does not aim to localize esophageal foreign bodies only, but also to evaluate relevant local complications including perforation, fistulization, and pleural empyema. [13] In our study, 14 (58.3%) patients had undergone cervical and lung X-rays before endoscopic intervention. FBs were detected in 4 (16.7%) patients through X-ray (Figure 4).…”

Section: Discussionmentioning

confidence: 74%

Detection and endoscopic treatment of foreign bodies in the upper gastrointestinal system of the geriatric patients

Çoşkun

Çapraz

Kaya

et al. 2022

Journal of Contemporary Medicine

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Introduction: Ingestion of foreign bodies is a worldwide problem associated with severe morbidity and mortality. The incidence of foreign body ingestion increases in the elderly population due to impaired intraoral sensitivity and swallowing reflex, visual problems, tooth loss, and mental disorders. Material and Method: All patients admitted with foreign body ingestion were retrospectively screened between January 2016 and May 2020. The patients over 65 years of age were included for the study. All patients were managed by a flexible endoscope. Results:49 patients referred with the diagnosis of foreign body ingestion Geriatric population consisted of 24 (49%) patients, mean age was 77.4±7.8 years and 15 (62.5%) were male. The most common symptom at admission was dysphagia in 41.7% of patients. The most common ingested foreign bodies are meat and food in 58.3% of the patients (p<0.01). Foreign bodies were most often stuck at the upper esophageal sphincter level (50%). Our average time to perform endoscopic intervention was approximately 3 hours after patients were admitted to the emergency room. Perforation due to chicken bones was detected in 2 patients, and both patients recovered after follow-up without the need for surgical intervention, and additive endoscopic intervention. Our success rate is 100% after endoscopic procedures, and no complications or death secondary to the procedure were observed in none of the patients. Conclusion: Endoscopic foreign body removal is a highly effective procedure with relatively low complication and mortality rates. Immediate endoscopic intervention should be performed in patients who ingest foreign body to reduce the risk of complications.

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“…With the intention of using a flap for esophageal repair, intercostal muscle flap should be harvested before placing a rib spreader to avoid traumatizing vascular pedicle. The role of buttress technique was confirmed by several authors and that has definitely improved the outcome of the surgical treatment and reinforcement with vascularized tissue decreases the fistula formation (13%) and mortality (6%), compared to repair without reinforcement (39%) and (25%) [2,14,12,20]. Besides, there are various other local tissues at the site of perforation have been used to buttress the primary repair, such as pleural flaps, omental flaps, diaphragm and pericardial flaps, etc.…”

Section: Discussionmentioning

confidence: 97%

Acute Mediastinitis Following Esophageal Perforation with Swallowing of Duck Bone: A Case Report

Khang¹

2021

IJCTS

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Background: Acute mediastinitis is still associated with a high morbidity and mortality. Mediastinitis secondary to esophageal perforation is a rare but potentially life-threatening condition. Case presentation: This report aims to present an acute mediastinitis case, in a 54-year-old healthy female patient, which originated from an intrathoracic esophageal perforation with swallowing of duck bone that confirmed by computed tomography of the chest. The patient was successfully treated by an emergency left thoracotomy, effective surgical drainage and aggressive debridement of the affected mediastinal compartments, primitive repair of perforated esophagus with intercostal muscle flap, decompressive gastrostomy and jejunostomy for feeding. Post-operatively, the patient was benefited from broad-spectrum antibiotics, intensive care and resuscitation associated with a close follow-up consequence. Results: Mediastinitis was well-controlled. Post interventional computed tomography scan with hydro-soluble contrast ingestion showed no extraluminal leak and good integrity of esophagus. The patient restored normally oral feeding without any complications and was discharged after 24 days of hospitalization without any sequelae. Conclusions: Early diagnosis is critical for expediting the choice of an optimal treatment strategy and plays an important role in improving mortality from acute mediastinitis following perforated esophagus. Besides intensive care and resuscitation, we advocate an emergency thoracic surgery for cases with established mediastinitis following intrathoracic esophageal perforation.

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Acute Mediastinitis Associated with Foreign Body Erosion from the Hypopharynx and Esophagus

Cited by 15 publications

References 14 publications

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract of Adults

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract of Adults

Detection and endoscopic treatment of foreign bodies in the upper gastrointestinal system of the geriatric patients

Acute Mediastinitis Following Esophageal Perforation with Swallowing of Duck Bone: A Case Report

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