Iatrogenic oesophageal perforation

Case contributed by Dr Lukas Valkovic

Presentation

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.

Patient Data

Age: 83
Gender: Male
Modality: CT

There is a pneumomediastinum with also emphysema in the neck and upper chest regions due to esophageal perforation in its middle third rear wall.

Case Discussion

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.

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Case Information

rID: 45650
Case created: 2nd Jun 2016
Last edited: 2nd Jun 2016
Inclusion in quiz mode: Excluded

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