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Esophageal perforation and its treatment

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Meaty meal eaten at speed. Chest pain.

Patient Data

Age: 50 years
Gender: Male

Normal prevertebral soft tissue.

No gas in the soft tissues of the neck.

Endoscopy performed.

High-density material in the mid esophagus in keeping surgical staples.

Extensive pneumomediastinum and surgical emphysema in the neck.

Lungs clear.

Fluoroscopy

Staples in the mid esophagus.

No contrast extravasation to suggest a leak.

Fluoroscopically guided...

Fluoroscopy

Fluoroscopically guided nasogastric tube insertion

Staples in the mid esophagus.

An NG tube was positioned under fluoroscopic guidance. 

Case Discussion

A rather hurried meaty meal resulted in this esophageal perforation.

It was treated conservatively with endoscopically applied staples and nasogastric tube insertion to allow the tear to heal.

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