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Trans-hiatal repair for Oesophageal and Junctional perforation: a case series.

ABSTRACT: BACKGROUND:Oesophageal perforation is a life-threatening condition that requires urgent intervention. Surgical repair is recommended within 24?h of onset to minimise mortality risk, traditionally via an open thoracotomy or a laparotomy. Primary oesophageal repair via a laparoscopic trans-hiatal approach has been seldomly reported due to concerns of inadequate eradication of soilage in the mediastinum and pleural space, as well as poor access and an increased operative time in an unwell population. CASE PRESENTATION:We report a case series of 3 oesophageal and junctional perforations with varying presentations, demonstrating how the laparoscopic trans-hiatal approach can be used successfully to manage oesophageal perforations. CONCLUSIONS:Laparoscopic trans-hiatal repair is an attractive option for oesophageal and junctional perforations, in haemodynamically stable surgical candidates, in the absence of gross contamination of the thoracic cavity.

SUBMITTER: Lee AHH

PROVIDER: S-EPMC7053070 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Trans-hiatal repair for Oesophageal and Junctional perforation: a case series.

Lee Adele H H AHH Kweh Barry T S BTS Gillespie Carla C Johnson Mary Ann MA

BMC surgery 20200302 1

<h4>Background</h4>Oesophageal perforation is a life-threatening condition that requires urgent intervention. Surgical repair is recommended within 24 h of onset to minimise mortality risk, traditionally via an open thoracotomy or a laparotomy. Primary oesophageal repair via a laparoscopic trans-hiatal approach has been seldomly reported due to concerns of inadequate eradication of soilage in the mediastinum and pleural space, as well as poor access and an increased operative time in an unwell p ...[more]

PMID: 32122343

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Thoracic endovascular aortic repair in management of aorto-oesophageal fistulas: a case series.

Project description:BackgroundAorto-oesophageal fistula (AOF) is a rare, catastrophic disease with an extremely poor prognosis. A ruptured thoracic aortic aneurysm is a common aetiology for AOF. The clinical presentation is usually massive haematemesis and collapse. Timely diagnosis and appropriate treatment are crucial in managing AOF.Case summaryWe hereby report two cases of AOF, who underwent successful emergency thoracic endovascular aortic repair (TEVAR) to control active bleed and exsanguination. Case 1, an elderly lady with atherosclerotic aneurysm had TEVAR followed by open surgery for oesophageal rent and necrosed left main bronchus. Case 2 had mycotic tubercular aneurysm who later had infected graft-stent following TEVAR.DiscussionOpen surgery is the conventional treatment for AOF; however, TEVAR can be an alternative and less invasive approach in selected high-risk patients. Various management issues related to TEVAR with AOF have been discussed in the article.

| S-EPMC7649481 | biostudies-literature

Emergency Laparoscopic Repair of an Iatrogenic Gastric Perforation in a Hiatal Hernia following a Failed Endoscopic Closure.

Project description:Iatrogenic gastrointestinal perforation is a rare, life-threatening complication of endoscopic procedures, which requires either endoscopic or surgical repair. We report the account of an 82-year-old woman with an iatrogenic gastric perforation of a hiatal hernia secondary to an endoscopic retrograde cholangiopancreatography (ERCP) procedure. Despite immediate recognition of the complication and endoscopic closure with through-the-scope (TTS) clips, the patient developed mediastinitis, peritonitis, and sepsis. She subsequently underwent an emergency laparoscopic hiatal hernia dissection and repair of the perforation with mediastinal and peritoneal washout. Given the patient's age and the degree of insult, subdiaphragmatic anchoring with abdominal drain placement was performed, and the hiatus was left open for additional drainage. The use of a side-viewing duodenoscope with the presence of a large hiatal hernia contributed to the risk of gastric perforation. We conclude that performing endoscopic procedures in patients with a known hiatal hernia should be carefully undertaken. If a perforation in such patients occurs, laparoscopic repair of such complications is feasible as demonstrated in this case video.

| S-EPMC7215237 | biostudies-literature

Primary repair of esophageal perforation: Case report.

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Oesophageal perforation: an unexpected complication during extraction of a pacing lead. A case report.

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Traumatic esophageal perforation in Puerto Rico Trauma Hospital: A case-series.

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| S-EPMC6611994 | biostudies-literature

High altitude area - A risk factor for gastric perforation? : A case series.

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Distinction of junctional cancers of gastric and oesophageal origin (DJANGO)

Project description:This SuperSeries is composed of the SubSeries listed below.

2019-03-01 | GSE96669 | GEO

Gastric necrosis following a hiatal hernia: A case report.

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Distinction of junctional cancers of gastric and oesophageal origin (DJANGO), batch#2

Project description:Aim of the study was the distinction of adeoncarcinomas at the gastroesophageal junction by their expression profile. Differential gene expression analysis between tumours of different Siewert type did not reveal relevant results. Stratification into three intrinsic subgroups was done by an diagonal distribution model using the mclust package in R. Clinicopathological and demographic parameters showed a similar distribution within the subgroups. Genes set ernichment analysis revealed different biological features for each subgroup that were also reflected by significant differences in the prognostic outcome for the patients, mainly overall survival and recurrence free survival.

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