Iatrogenic esophageal perforation

Case contributed by Dr Badis Al Harbawi

Presentation

Severe chest pain post-balloon dilatation of the oesophagus.

Patient Data

Age: 40 years
Gender: Female

Water-soluble oral contrast was administered just before imaging.

Status post-balloon dilatation of the esophagus. 

A long tear on the left side of the distal third of the esophagus a few centimeters distal to the carina and ends slightly above the diaphragm with a leak of contrast through the defect.

The gastroesophageal junction is intact but appears thickened.

Significant pneumomediastinum is noted. Minimal left pleural effusion.

Bronchiectasis in the right middle lobe and lingula and to a lesser extent in the lower lobes.

The rest of the lungs are clear. No mediastinal or hilar masses or lymph node enlargement could be seen.

No pericardial effusion.

Case Discussion

The patient went to the operating theater and an approximately 6 cm long tear was found in the distal esophagus and repaired by the thoracic surgeon.

Iatrogenic esophageal perforation is by far the most common cause of esophageal perforation.

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Case information

rID: 70015
Published: 30th Jul 2019
Last edited: 15th Sep 2019
Inclusion in quiz mode: Included
Institution: Ibn Al Haitham hospital

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