Cases reported "Esophageal Perforation"

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1/244. Unusual site for oesophageal perforation in an extremely low birth weight infant.

    A male infant born at 26 weeks gestation became unwell at 10 days of age with blood-stained pharyngeal aspirates. The chest radiograph revealed a feeding tube in the right pleural cavity, indicating a perforation of the thoracic oesophagus. The infant had had a chest drain inserted on the right side on two previous occasions. These had been allowed to remain across the mediastinum at the site of the subsequent perforation. The infant was successfully managed conservatively with no long-term sequelae The unusual site of the perforation led us to conclude that pressure necrosis from the drains was a contributing factor in the aetiology. CONCLUSION: Oesophageal perforations in the neonate, in contrast to the adult, can be managed conservatively.
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keywords = esophagus
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2/244. Perforation of the intrathoracic esophagus from blunt trauma in a child: case report and review of the literature.

    rupture of the intrathoracic esophagus from blunt trauma is an exceedingly rare injury in children and often presents on a delayed basis. The authors encountered a case of this unusual injury and review six additional cases found in the literature.
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3/244. Esophagoaortic perforation by foreign body (coin) causing sudden death in a 3-year-old child.

    We report an extremely unusual consequence to foreign body ingestion in a case of a 3-year-old boy who died suddenly and at autopsy was found to have an esophagoaortic fistula. This fistula was caused by a coin which lodged posteriorly and eroded through the esophagus into the aorta. Serious complications following foreign body ingestion are rare and include stricture formation, intramural abscess, and the formation of fistula tracts. This case illustrates the potentially unpredictable behavior of impacted foreign bodies. The child's parents were initially suspected of child abuse based on the terminal hemoptysis.
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4/244. Heterotopic gastric mucosa in the upper esophagus ("inlet patch"): a rare cause of esophageal perforation.

    We report the case of a 21-yr-old woman who presented with a perforation of an upper esophageal ulcer on a patch of gastric-type mucosa. Despite surgical closure of the perforation and reinforcement with a pleuro-muscular flap the patient developed an esophageal leakage and died in the postoperative period. Heterotopic gastric mucosa in the upper esophagus is usually an asymptomatic abnormality, discovered incidentally during endoscopic studies carried out for some other reason; however, complications secondary to the inlet patch acid secreting capacity can arise, and this has to be kept in mind to elude life-threatening conditions.
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keywords = esophagus
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5/244. Submucosal esophageal dissection--a rare case report.

    The severity of submucosal dissection is intermediate between transmural rupture and mucosal tear in the esophagus. We describe a case of submucosal dissection of the esophagus with characteristic features of mucosal bridge endoscopically and "double-barreled" in radiography. The patient was successfully treated by intermittent esophageal tamponade of 5-day duration using a Sengstaken-Blackmore tube, and total parenteral nutrition. His course was uneventful in a follow-up period of 5 years.
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keywords = esophagus
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6/244. Button battery ingestion: hazards of esophageal impaction.

    Ingestion of button batteries has been seen with increasing frequency over the past decade. In a small number of reported cases, their impaction in the esophagus has led to serious, sometimes fatal, complications. The management of these cases has varied from expectant, supportive therapy to early surgical intervention. The authors report 2 pediatric patients in whom esophageal perforation developed after impaction of a disc battery. Both were treated conservatively with successful outcomes.
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keywords = esophagus
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7/244. A report of three cases with an oesophageal perforation treated with a coated self-expanding stent.

    A perforation of distal oesophagus in benign cases occurs usually as a complication of endoscopic procedures or due to perforating external trauma. Perforations caused by blunt trauma are rare and usually involve high-energy accidents. The time of diagnosis, severity of the perforation, degree of mediastinal and pleural contamination and treatment are the most important factors predicting the outcome. Treatment may be conservative, comprise primary suturation or include oesophageal resection. We present three cases with a benign oesophageal perforation, which we have treated with a coated stent. One of the cases suffered from a thoracic oesophageal perforation due to a lesser trauma, while the other two cases are perforations caused by complications of endoscopy.
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8/244. Spontaneous oesophageal perforation due to mediastinal tuberculous lymphadenitis - atypical presentation of tuberculosis.

    Spontaneous non-traumatic oesophageal perforation secondary to bursting of a mediastinal tuberculous abscess into the oesophagus is rare. The diagnosis is delayed, as perforation remains localised due to mediastinal lymph nodes. Patient can be effectively managed by paraoesophageal drainage of the mediastinal abscess and oesophageal diversion.
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9/244. Respiratory distress due to esophageal perforation caused by ball point ingestion.

    A 15-month-old girl who developed respiratory distress which persisted for three days prior to admission demonstrated pleural effusion on the chest x-ray which was determined to be due to esophageal perforation caused by the ingestion of a ball point. A gastrotomy was performed to extract the ball point. A gastrostomy was performed and a chest tube was inserted. The esophagus was normal radiologically within one month. Foreign body ingestion may cause esophageal perforation in childhood. If it goes unnoticed and a diagnosis is delayed, there is danger of the more hazardous development of mediastinitis. It is important that a child with respiratory distress also be evaluated for esophageal foreign body ingestion.
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10/244. Oesophageal perforation following perioperative transoesophageal echocardiography.

    Transoesophageal echocardiography (TOE) is being used more often by cardiothoracic anaesthetists for the perioperative management of cardiac problems. Reports of iatrogenic oesophageal perforation by instrumentation of the oesophagus are increasing. Although TOE is considered safe, it may be more risky during surgery, because the probe is passed and manipulated in an anaesthetized patient. It may be in place for several hours so the risk of mucosal pressure and thermal damage is increased. patients on cardiopulmonary bypass are also fully anticoagulated. We describe a case of oesophageal perforation following insertion of the TOE probe in a patient with gross cardiomegaly. Oesophageal distortion by cardiac enlargement may increase the risk of oesophageal perforation. Difficulty in passage of the TOE probe should be regarded with suspicion and withdrawal should be contemplated because the symptoms of oesophageal perforation are often delayed and non-specific. Delay in investigation, diagnosis and treatment will increase morbidity and mortality.
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