Iatrogenic oesophageal perforation
83 year old patient with a tumorous circular esophageal stenosis in the upper third of the esophagus and with clinically significant dysphagia. He underwent gastrofibroscopic dilatation with sudden onset of pain and shortness of breath.
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There is a pneumomediastinum with also emphysema in the neck and upper chest regions due to esophageal perforation in its middle third rear wall.
Immediately an urgent CT was performed, which verified a lesion in the esophagus at the site of the tumor and stenosis. A self-expanding stent under fluoroscopic control was loaded. After 5 days of treatment GFS was performed, which assessed a correct position of the stent. Also a sip of contrast agent verified free passage to the stomach, with no signs of extraluminal leakage into the mediastinum. After 6 days patient could receive fluids without complications.