Diagnosis and Recommended Management of Esophageal Perforation and Rupture

Bladergroen, Mark; Lowe, James E.; Postlethwait, R. W.

doi:10.1016/s0003-4975(10)62725-7

Cited by 275 publications

(144 citation statements)

References 17 publications

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“…The overall mortality rate of oesophageal perforation i~rom all causes is approximately 21%, compared with 6% in uncomplicated cervical oesophageal perforation. 3,4 In this case, a tract extending from the retropharyngeal space to the mediastinum was established by the nasogastafc tube. This likely resulted in mediastinal contamination, and so primary repair of the oesophageal laceration was undertaken.…”

Section: Discussionmentioning

confidence: 87%

Intrapleural placement of a nasogastric tube: an unusual complication of nasotracheal intubation

Fisman

Ward

1996

Can J Anaesth

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Misplacement of nasogastric tubes into the pleural space is a rare occurrence, generally associated with transbronchial placement of narrow-bore feeding tubes with metal stylets. L2 We present a case which illustrates the potential for intrapleural placement of a polyvinyl chloride nasogastric tube frllowing traumatic nasotracheal intubation. The case highlights the possibility of oesophageal perforation during both nasogastric and nasotracheal intubation, and the potential for particularly severe injury when complications of both procedures occur in tandem. Since nasogastric intubation often fol-CAN J ANAESTH 1996 / 43:12 /pp1252~fi

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Section: Discussionmentioning

confidence: 87%

Intrapleural placement of a nasogastric tube: an unusual complication of nasotracheal intubation

Fisman

Ward

1996

Can J Anaesth

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“…If undiscovered, an oesophageal perforation inevitably results in mediastinitis and sepsis. The mortality rate of this condition is up to 40% [4,11,12,14,16,18,22]. Cherveniakov et al [6] emphasise the importance of early treatment, and report a delayed diagnosis due to failure to recognise the clinical symptoms in 55% and due to misinterpretation of X-ray findings in another 25% in their series of 147 patients.…”

Section: Discussionmentioning

confidence: 99%

“…Cherveniakov et al [6] emphasise the importance of early treatment, and report a delayed diagnosis due to failure to recognise the clinical symptoms in 55% and due to misinterpretation of X-ray findings in another 25% in their series of 147 patients. Generally, a delay between diagnosis and therapy of more than 24 h has been found to adversely affect the outcome [4,9].…”

Section: Discussionmentioning

confidence: 99%

Extension injury of the thoracic spine with rupture of the oesophagus and successful conservative therapy of concomitant mediastinitis

et al. 2009

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The case of an upper oesophageal perforation as a concomitant injury of an isolated fracture of the upper thoracic spine without neurological compromise has not been described so far. A Case report and review of the literature is presented here. Concomitant oesophageal perforations carry a high risk of being missed initially. CT alone can visualize the subtle indirect signs like peri-oesophageal air. The literature revealed that only peri-oesophageal air might be a valid indicator of oesophageal injury. There are no systematic data on thoracic spine fractures with concomitant oesophageal perforations. Mediastinitis secondary to oesophageal perforation might be treated conservatively with endoscopic stent placement rather than surgically. As the radiological signs of concomitant soft tissue injury, like oesophageal perforations, in fractures of the upper thoracic spine are subtle and easily missed initially only anticipation of concomitant injuries by the treating physician based on the trauma mechanism ensures a timely diagnosis.

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“…Aniatrogenic cause is found in 55% of the cases of perforation, followed by spontaneous rupture in 15%, foreign body perforation in 14%, and traumatic perforation in 10%. Bladergroen et al (8). reported a total of 127 patients with this disorder, excluding patients with anastomotic leak after esophageal surgery and those in whom perforation occurred in association with carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to early treatment, other factors associated with a favorable outcome included traumatic perforation ( 100% survival), foreign-body perforations (94% survival), and iatrogenic causes (80%survival). Spontaneousrupture was associated with the lowest survival (37%) (7)(8)(9). Patients with esophageal perforation frequently present with an antecedent history of vomiting followed by chest pain.…”

Section: Discussionmentioning

confidence: 99%

Esophageal Perforation Associated with Profound Shock Successfully Managed with Hemodynamic Assistance Using Percutaneous Cardiopulmonary Support.

et al. 2000

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A 51-year-old man was admitted to our hospital with complaints of severe chest pain, nausea, and vomiting. These symptoms had progressed rapidly and he was in shock. It wasnecessary to makea correct diagnosis as early as possible. However, the hemodynamic condition of the patient deteriorated rapidly before a definitive diagnosis could be established in spite of conventional therapies. Under hemodynamic assistance with percutaneous cardiopulmonary support (PCPS), a final diagnosis of esophageal perforation was made by esophagography. Our report illustrates a new application of PCPS for highly selected cases of noncardiogenic shock as a "bridge" until an accurate diagnosis is made and a specific treatment is applied. (Internal Medicine 39: 936-939, 2000)

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Diagnosis and Recommended Management of Esophageal Perforation and Rupture

Cited by 275 publications

References 17 publications

Intrapleural placement of a nasogastric tube: an unusual complication of nasotracheal intubation

Intrapleural placement of a nasogastric tube: an unusual complication of nasotracheal intubation

Extension injury of the thoracic spine with rupture of the oesophagus and successful conservative therapy of concomitant mediastinitis

Esophageal Perforation Associated with Profound Shock Successfully Managed with Hemodynamic Assistance Using Percutaneous Cardiopulmonary Support.

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