Case report of a conservative management of cervical esophageal perforation with acrylic glue injection

Abstract

Backgroundperforation of the upper aerodigestive tract is a potentially life-threatening condition. The appropriate treatment of cervical esophageal perforation is still controversial.Case presentationwe report a case of cervical esophageal perforation that was effectively treated by a conservative management with acrylic glue injection.Discussionthe management of cervical esophageal perforations has been controversial and little studied. Various treatment options, including surgical and nonsurgical management have been advocated, and no gold standard surgical treatment has yet been established. Some authors have recommended immediate surgical intervention, especially in penetrating trauma, conversely, several studies support conservative management.Conclusionswe consider that the application of acrylic glue can be considered a promising, minimally invasive therapeutic option in the management of cervical esophageal perforation. However, the sufficient accumulation of similarly treated cases is necessary in order to confirm the efficacy and safety of this treatment modality.

Cyanoacrylate in Colorectal Surgery: Is It Safe?

“…Between other applications of CA, the treatment of upper and lower gastrointestinal fistulas was one of the most interesting. A few case reports were presented in the literature [54][55][56][57]. In details, Anoldo et al [54] reported a case of cervical esophageal perforation that was successfully treated with CA injection after the failure of other conservative options.…”

“…A few case reports were presented in the literature [54][55][56][57]. In details, Anoldo et al [54] reported a case of cervical esophageal perforation that was successfully treated with CA injection after the failure of other conservative options. Thus, it was possible to consider CA a promising minimally invasive alternative for the treatment of cervical esophageal perforation.…”

Management of Iatrogenic Cervical Esophageal Perforations

“…Fibrin has tissue-healing properties and is used for sealing, and cyanoacrylate can be used with clips to ensure closure. 17 Anoldo et al 69 described a fast recovery with the application of cyanoac-rylic glue into the fistula opening in a case of an iCEP. They attributed this favorable result to the glue's adhesive and hemostatic properties, high tensile resistance, and antibacterial characteristics.…”

“…However, conservative management with glue is not recommended if the output from the fistula is of high volume exceeding 500 mL in 24 hours. 69 Endoscopic vacuum-assisted closure is also a recent novel technique. It is used to drain mediastinal abscesses and involves positioning a small sponge placed with the help of an endoscope that suctions with a negative-pressure pump.…”

“…They attributed this favorable result to the glue’s adhesive and hemostatic properties, high tensile resistance, and antibacterial characteristics. However, conservative management with glue is not recommended if the output from the fistula is of high volume exceeding 500 mL in 24 hours . Endoscopic vacuum-assisted closure is also a recent novel technique.…”