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Endoscopic T-tube placement in the management of lye-induced esophageal perforation: Case report of a safe treatment strategy.

ABSTRACT: Esophageal perforation is associated with a significant risk of morbidity and mortality. We report herein a case of lye-induced esophageal perforation managed successfully by employing endoscopic T-tube placement with a successful outcome.

SUBMITTER: McMahon MA

PROVIDER: S-EPMC2738658 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Endoscopic nasobiliary drainage tube placement through a periampullary perforation for management of intestinal leak and necrotizing pancreatitis

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Endoscopic vacuum therapy for a large esophageal perforation after bariatric stent placement.

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Primary repair of esophageal perforation: Case report.

Project description:INTRODUCTION:Mortality after esophageal perforation is high irrespective of the treatment modality. The rarity of traumatic esophageal perforations has made it difficult to conduct comprehensive studies that can answer pertinent questions with regard to management. PRESENTATION OF CASE:We report a case of through and through thoracic esophageal injury caused by an assailant's arrow in a young physically active male adult. Diagnosis was made on-table. He successfully underwent primary repair of the esophageal injury 16?h post injury via a left thoracotomy. Recurrent lung collapse and pleural effusion was managed with tube thoracostomy and chest physiotherapy. DISCUSSION:Esophageal perforations occur infrequently and may produce vague symptoms leading to diagnostic and therapeutic delays. High index of suspicion particularly in penetrating chest trauma followed by relevant investigations may reduce delay. Principles of management include treatment of contamination, wide local drainage, source control and nutritional support. Source control is achieved surgically or through endoluminal placement of stents. Surgical options include primary repair, creation of a controlled fistula by T-tube or esophageal exclusion. CONCLUSION:Primary repair of traumatic injury to a healthy esophagus is feasible for cases diagnosed early and without significant mediastinal contamination as in our case. Associated injuries are more likely in such cases to lead to increased morbidity and prolonged hospital stay and must be handled carefully.

| S-EPMC7248577 | biostudies-literature

Jejunal perforation during peritoneal dialysis catheter placement: A case report.

Project description:IntroductionBowel perforation is a rare but serious complication after peritoneal dialysis (PD) catheter insertion, which significantly increases mortality. Currently, there is no recommendation for preferring catheter insertion technique, since neither open surgical or percutaneous technique demonstrate superior outcome.Presentation of caseThis is a 78-year-old man who developed jejunal perforation during PD catheter placement, presenting with initial clear and satisfying PD fluid drainage. Bowel perforation was recognized after long dwell of PD fluid returned in yellowish color. Operative finding revealed a through and through jejunal wall perforation.ConclusionSatisfying dialysate flow and tip catheter location could not exclude accidental bowel perforation after PD catheter placement. Carefully patient monitoring is crucial in detecting postoperative complication.

| S-EPMC7374195 | biostudies-literature

Obstructive shock due to tracheal perforation following long-term placement of a tracheostomy tube in a pediatric patient: a case report.

Project description:BackgroundTracheal perforation, although rare, is a known late complication of tracheostomy tube placement.Case presentationWe present a 7-year-old boy with severe physical and mental disabilities under tracheostomy and long-term mechanical ventilation and steroid therapy who suddenly developed obstructive shock secondary to pneumomediastinum and pneumothorax. Prior bronchoscopy had shown the tip of the tracheostomy tube contacting the posterior tracheal wall, causing ulceration and subsequent tracheal perforation. The perforation was bridged using a cuffed tracheostomy tube, but the patient subsequently died of additional comorbidities.ConclusionsOur experience suggests that tracheal perforation should be considered when pediatric patients with tracheostomy tubes suddenly develop hypotension.

| S-EPMC9023623 | biostudies-literature

Successful Endoscopic Removal of a Kerh-Tube Placed in an Iatrogenic Esophageal Perforation: Push to Pull.

Project description: Not available

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Esophageal perforation by tilapia fish bone ingestion - A case report.

Project description:INTRODUCTION:Esophageal perforation (EP) is a rare, severe and challenging surgical emergency which can be caused by several factors. This report presents the case of a patient with EP caused by ingestion of a Tilapia fish bone. PRESENTATION OF CASE:A 41-year-old male patient presented with a six-day history of painful right-sided neck swelling, associated with a progressive dysphagia, regurgitation, fever and chills. Physical examination revealed an axillary temperature of 39?°C and a subcutaneous emphysema in the neck. Cervical spine x-ray and ultrasound scan revealed a neck foreign body with abscess. The case was managed by a right cervicotomy. DISCUSSION:Despite over 20-years of clinical experience in Ghana, this was the first case of EP caused by a 2?cm long Tilapia fish bone, to be treated by the authors. This is significant because tilapia consumption is very popular in Ghana and it would be predicted that such cases would be more common. It is suggested that such cases do occur more frequently but are not reported to hospitals due to cultural-spiritual beliefs. CONCLUSION:Ingestion of Tilapia fish bones can cause significant damage to the esophagus and Tilapia should be consumed with care. Ultrasound is a very useful tool with high diagnostic accuracy for EP. Further studies are needed to establish the prevalence of EP from fish bone ingestion in Ghana and the factors accounting for the mismatch between the high consumption of Tilapia across the population and the low occurrence of patients presenting with EP from fish bone ingestion.

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Colonic Perforation After Treatment With Nivolumab in Esophageal Cancer: A Case Report.

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Severe tracheal stenosis due to prolonged tracheostomy tube placement: a case report.

Project description:Tracheal stenosis is the most common late airway complication of tracheostomy. Severe tracheal stenosis resulted in hemodynamic deterioration and impairment of respiratory system mechanics. We cared for an 86-year-old man with severe tracheal stenosis due to prolonged placement of a tracheostomy tube for 42-months. At the distal tip of the tracheostomy tube, bronchoscopy revealed severe tracheal luminal obstructions by granulation tissue. During pressure-controlled ventilation, the peak airway pressure was much higher than the inspiratory pressure. For patients with clinical signs of tracheal stenosis after tracheotomy, bronchoscopy should be done as early as possible.

| S-EPMC2769338 | biostudies-literature

Drainage Tube Placement May Not Be Necessary During Endoscopic Thyroidectomy Bilateral Areola Approach: A Preliminary Report.

Project description:BackgroundThe endoscopic thyroidectomy bilateral areola approach (ETBAA) improved cosmetic outcomes significantly and is now widely applied. The usage of drainage tubes is controversial in conventional open thyroidectomy (COT), but studies about drainage placement decisions during ETBAA are still limited. This study aimed to determine the feasibility of having no drainage tube applied during ETBAA on patients with papillary thyroid carcinoma.MethodsThe clinical data of patients undergoing ETBAA from July 2018 to May 2021 was retrospectively collected. The patients were divided into two groups based on drain placement: no-drain and drain. The two groups were matched at a ratio of 1:1. Fifty-five patients from each group were finally included. Postoperative complications and follow-up data were compared between the two groups.ResultsNo significant difference was observed between the two groups in the incidence of postoperative complications, including hemorrhage, surgical site infection, and subcutaneous seroma. Compared with the drain group, the operation time of the no-drain group was significantly shorter [(107.75 ± 24.59) min vs. (119.91 ± 34.05) min, P < 0.05]. The total and postoperative hospital stay was significantly shorter in the no-drain group [(2.40 ± 0.71) days vs. (4.78 ± 1.33) days, P < 0.001, (2.04 ± 0.19) days vs. (2.15 ± 0.36) days, P < 0.05], and the costs of surgical consumables were also significantly lower [(6,820.83 ± 164.29) CNY vs. (7,494.13 ± 216.7) CNY, P < 0.05]. The postoperative pain score of the no-drain group was significantly lower than the drain group [(1.58 ± 0.63) vs. (1.89 ± 0.76), P < 0.05].ConclusionsNo drainage applied during ETBAA on papillary thyroid carcinoma is safe and feasible. This practice does not increase the risk of postoperative complications, but it does shorten the operation time and hospital stay, as well as reduce medical costs. Furthermore, it alleviates the suffering of patients.

| S-EPMC8960029 | biostudies-literature

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