Oesophageal perforation

Carrascosa, Miguel F; Herreras-Martínez, Rosa; Trugeda-Carrera, Soledad; Terán, Álvaro; Fernández-Díaz, María José; Concha, Sergio Tapia; Saiz-Quevedo, José A

doi:10.1016/s2468-1253(18)30179-1

Cited by 3 publications

(3 citation statements)

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“…The incidence of EF in EC patients receiving chemoradiotherapy is about 4.3%–22% according to previous studies ( 3 – 10 ). The common clinical symptoms of EF include bucking, back/chest/abdominal pain, fever, hydrothorax, dysphagia, and empyema ( 11 ). Therefore, early prediction of EF and appropriate intervention are important to enhance clinical outcomes and increase quality of life.…”

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confidence: 99%

A Nomogram for Predicting the Risk of Radiotherapy-Related Esophageal Fistula in Esophageal Cancer Patients

et al. 2022

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BackgroundTo construct and validate a nomogram for predicting the risk of esophageal fistula in esophageal cancer patients receiving radiotherapy.MethodsA retrospective nested case–control study was performed, in which a total of 81 esophageal fistula patients and 243 controls from 2014 to 2020 in the First Affiliated Hospital of Anhui Medical University were enrolled. Factors included in the nomogram were determined by univariate and multiple logistic regression analysis. The following methods including ROC curve, C-index, calibration curves, Brier score, and decision curve analysis (DCA) were adopted to evaluate this nomogram.ResultsMultivariate logistic regression analysis showed that T4 stage, level 4 stenosis, ulcerative esophageal cancer, prealbumin, and maximum diameters of GTV and NLR were the independent risk factors of esophageal fistula. Accordingly, a nomogram incorporating the aforementioned six parameters was constructed. The AUC was 0.848 (95% CI 0.901–0.895), indicating a high prediction accuracy of this nomogram. Further evaluation of this model showed that the C-index was 0.847, while the bias-corrected C-index after internal validation was 0.833. The Brier score was 0.127. The calibration curves presented good concordance, and the DCA revealed promising clinical application.ConclusionsThe nomogram presents accurate and applicable prediction for the esophageal fistula risk in esophageal cancer patients receiving radiotherapy.

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Section: Introductionmentioning

confidence: 99%

A Nomogram for Predicting the Risk of Radiotherapy-Related Esophageal Fistula in Esophageal Cancer Patients

et al. 2022

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“…La perforación esofágica es una condición que amenaza la vida, presentando una mortalidad de hasta 40% que puede duplicarse a las 24 horas si esta no es diagnosticada. La ingestión de cuerpos extraños y las iatrogenias son sus causas más comunes 1 .…”

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Manejo quirúrgico de perforación esofágica

Yrigoin¹,

Cydejko²,

Bran³

et al. 2022

Interciencia méd.

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Mujer de 42 años con diagnóstico de acalasia, admitida en la institución para dilatación neumática esofágica. En el procedimiento se evidencia a 20mm de la unión gastroesofágica diagnosticándose perforación esofágica una solución de continuidad de 25 mm. Se maneja con stent metálico autoexpandible totalmente cubierto, rafia del defecto vía laparoscópica y drenaje torácico, paciente pasa a Unidad de Cuidados Intensivos, presenta evolución favorable y obtiene su alta médica en el décimo día de hospitalización.

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“…Mediastinitis due to esophageal perforation (MEP) can be observed regardless of the cause of the perforation, as the rupture leads to the spillage of gastric fluid, contaminating the mediastinum with digestive flora. It is mostly iatrogenic, in 50% of cases [ 11 , 12 ], but it can also be spontaneous or traumatic. Finally, mediastinitis of oropharyngeal origin, also known as descending necrotizing mediastinitis (DNM), is due to the spread of an infection from the cervical sphere along the fascia to the mediastinum.…”

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Infectious Mediastinitis: A Retrospective Cohort Study

Lemmet,

Mazzucotelli,

Collange

et al. 2024

Open Forum Infectious Diseases

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Objective This study aimed to characterize the demographics, microbiology, management and treatment outcomes of mediastinitis according to the origin of the infection. Methods This retrospective observational study enrolled patients diagnosed with mediastinitis according to the criteria defined by the Centers for Disease Control and prevention, who were treated in Strasbourg University Hospital, France between January 1st, 2010 and December 31st, 2020. Results We investigated 151 cases, including 63 post-sternotomy mediastinitis (PSM), 60 cases of mediastinitis due to esophageal perforation (MEP) and 17 cases of descending necrotizing mediastinitis (DNM). Mean age was 63 ± 14.5 years old and 109/151 were male. Microbiological documentation varied according to the origin of the infection. When documented, cases with PSM were mostly monomicrobial (36/53, 67.9%) and involved staphylococci (36/53, 67.9%), whereas cases with MEP and DNM were mostly plurimicrobial (38/48, 79.2% and 8/12, 66.7%, respectively) and involved digestive or oral flora microorganisms, respectively. The median duration of anti-infective treatment was 41 days (interquartile range: 21–56), and 122/151 (80.8%) patients benefited from early surgical management. The overall 1-year survival was estimated to be 64.8% (95% CI; 56.6%–74.3%), but varied from 80.1% for DNM to 61.5% for MEP. Conclusion Mediastinitis represents a rare yet deadly infection. The present cohort study exhibited the different patterns observed according to the origin of the infection. Greater insight and knowledge on these differences may help guide the management of these complex infections, especially with respect to empirical anti-infective treatments.

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Oesophageal perforation

Cited by 3 publications

References 0 publications

A Nomogram for Predicting the Risk of Radiotherapy-Related Esophageal Fistula in Esophageal Cancer Patients

A Nomogram for Predicting the Risk of Radiotherapy-Related Esophageal Fistula in Esophageal Cancer Patients

Manejo quirúrgico de perforación esofágica

Infectious Mediastinitis: A Retrospective Cohort Study

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