• Korean Journal of Bronchoesophagology
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• v.14 no.1
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• pp.42-45
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• 2008

Tracheal injury associated with esophageal injury due to fish bone is very rare. Also, treatment of mediastinitis due to esophageal perforation when it is diagnosed late remains controversial. We report the case that we have successfully experienced treatment of mediastinitis due to tracheal and esophageal injury by fish bone.

• Korean Journal of Bronchoesophagology
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• v.5 no.1
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• pp.30-35
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• 1999

Between 1994 to 1998, 7 patients had taken emergency operations by iatrogenic esophageal perforation. To evaluate patterns of injury, clinical presentation, and treatment options for patients, we reviewed all the 7 patients who had gotten transmural injury to the esophagus during dilatations or stenting procedures at our hospital. The primary diagnosis of the patients were as followings , two were achalagia and remaining five were corrosive esophageal strictures. Chest pain, fever, tachycardia were the early signs after esophageal perforation. The sites of perforation were thoracic esophagus in all cases and all of them underwent operation within 8 hours of initial injury. There were no postoperative mortality. Complications were developed three cases： stricture of anastomotic site, mediastinitis due to graft failure of colon and pleural empyema.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.705-709
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• 2010

Background: Esophageal injury requires early and proper management. We want to determine the results of various esophageal injuries. Material and Method: We respectively analyzed 22 patients who were managed for esophageal injury between 1999 and 2009. Based on the medical records, we reviewed the causes of injury, the diagnoses, the treatment methods, the complications and the prognosis. Result: The main causes of esophageal injury were a foreign body in 9 cases (41%) and vomiting in 5 cases (23%). We treated the patients with esophageal primary repair in 12 cases (55%), abscess drainage in 4 cases (18%) and conservative management in 6 cases (27%). There was esophageal leakage in 7 cases (32%) and death occurred in 3 cases (14%). Conclusion: For minor esophageal injury, conservative management was sometimes possible to treat the esophagus, yet aggressive and urgent surgical treatment should be applied for cases of major esophageal injury, including mediastinal abscess.

• Journal of Chest Surgery
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• v.32 no.2
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• pp.198-200
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• 1999

Esophageal perforation due to the air pressure generated by forcefully evaporating gas is seldomly reported. If the diagnosis is confined to the injury of the oral cavity and the pharynx, missing the injury of the esophagus, the result may be fatal. Cases like this must be managed by early diagnosis and appropriate surgical intervention. The most important thing for early diagnosis is suspicion of esophageal injury from history and physical examination. We report two cases of esophageal pneumatic perforation caused by an explosive gas from the carbonated beverage bottle.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.342-347
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• 1989

A 4-year-old male developed the esophageal perforation after air-gun shut injury in the thorax. The esophageal perforation was found on esophagogram at the next day after the accident. Because of delayed diagnosis, mediastinitis and pyopneumothorax were developed. The general conditions of the patient were very critical with sepsis on admission. Therefore, two staged operation was planned. At the first stage, exclusion and diversion of the esophagus was carried out to treat chemical pneumonitis due to gastric contents through the esophago-bronchial fistula by gastroesophageal reflux. Clinical conditions of the patient were improved after the first stage operation. At the second stage, the esophageal reconstruction with right colon was performed.

• Acute and Critical Care
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• v.33 no.4
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• pp.276-279
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• 2018

In pediatric patients, a laryngeal mask airway (LMA) is usually used during minor surgeries that require general anesthesia. No esophageal injury has been reported after insertion of an LMA. We report a case of an esophageal injury with intramural dissection after an $i-gel^{(R)}$ (size, 1.5; Intersurgical Ltd.) insertion in a pediatric patient. A 2-month-old male infant was hospitalized for left inguinal herniorrhaphy. After induction of anesthesia, a trained resident tried to insert an $i-gel^{(R)}$. However, it was only successful after three attempts. Dysphagia was sustained until postoperative day 10, and the pediatrician observed duplication of the esophagus on gastroendoscopy. However, a whitish mucosal lesion, which looked like a scar, was observed, and previous lesions suggestive of esophageal duplication were almost healed on postdischarge day 11. His condition was diagnosed as dysphagia and esophagitis due to an esophageal laceration, not esophageal duplication. He was scheduled for symptomatic treatment with a proton pump inhibitor. In conclusion, although an esophageal injury or perforation in pediatric patients is rare, an LMA insertion or a procedure such as aspiration or nasogastric tube insertion should be performed gently to avoid a possible injury to the esophagus in pediatric patients.

• Journal of Korean Neurosurgical Society
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• v.37 no.2
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• pp.141-145
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• 2005

We report five patients of esophageal injuries confirmed by clinical signs and radiological evidences. They include a partial tear and a perforation which were not noticed during the operation, a perforation which was primarily repaired during the operation, and two perforations which occurred during the reoperations for the removal of mal-positioned screws or plate. The partial tear was not repaired. The perforation which occurred during the operation was primarily sutured and didn't receive further treatment. Two perforations which occurred during the reoperations were treated by irrigation, debridement with surgical drainage, and systemic antiobiotics. One who was diagnosed later after the operation showed the poorest outcome and required longest hospital days among our series. Early detection and appropriate treatment of esophageal injury following anterior spinal surgery can only improve the prognosis by preventing secondary complications.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.278-282
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• 2012

An esophageal perforation following anterior cervical fusion is rare. Early development of an esophageal perforation after anterior cervical fusion is usually due to iatrogenic injury from retraction, injury associated with the original traumatic incident, improperly placed instruments or a bone graft. A 31-year-old man had a cervical dislocation and spinal cord injury because of severe cervical trauma after a traffic accident. He was quadriplegic and had no feeling below T4 dermatome. Anterior decompression of the cervical spine and anterior fusion with mesh with autobone were performed. An esophagocutaneous fistula occurred 7 days after anterior cervical surgery. A second anterior surgery was done because of pus drainage. The mesh was changed with an iliac bone graft, and the esophagocutaneous fistula site was primary repaired, but pus continued to drain. Conservative treatment, which consisted of wound drainage and intravenous administration of antibiotics, was tried, but was unsuccessful. After all, we removed the plate and screws, but did not removed the iliac bone graft, We closed the esophageal fistula, and transposed the sternocleidomastoid muscle flap to the interspace between the esophagus and the cervical spine. The wound to the esophagus was well repaired. In conclusion, precautionary measures are needed to avoid the complication, and adequate treatment is necessary to resolve those complications when they occur.

• Journal of Chest Surgery
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• v.27 no.4
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• pp.331-334
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• 1994

Pneumatic rupture is a rare cause of esophageal injury, as evidenced by only 19 cases reported in the literature. We experienced one case of esophageal rupture due to bursting of a truck inner tube. The patient, who was a 45-year old male, had severe chest pain, respiratory distress, flushing in the face and neck, and subcutaneous emphysema after tire explosion. Three days after the incident, a diagnosis of rupture of the thoracic esophagus was established by esophagogram using water soluble contrast media, and then emergency operation was done. The operation involved mediastinal and thoracic drainage and resection of the esophagus combined with cervical esophagostomy and feeding gastrostomy. On the 105th day after the operation, cervical esophagogastrostomy via substernal route was performed. The patient was successfully treated with the staged operations. As in the other reported cases, the injury was located in the lower one third of the esophagus. Four main characteristics of the clinical signs of pneumatic rupture are 1] wounds or burns to the face or mouth, 2] chest pain or epigastric pain, 3] subcutaneous emphysema, and 4] respiratory distress. We emphasize that the high index of suspicion of esophageal rupture is very important in diagnosis and that diagnosis should be based on the same findings common to other forms of esophageal injury.

• Korean Journal of Bronchoesophagology
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• v.4 no.2
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• pp.231-234
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• 1998

Esophageal perforation is uncommon, however, due to the lack of serosa layer inflammation spread is rapid and common to neighboring structures, leading to significant mortality and morbidity. With an advancement of endoscopic diagnosis there is an increase of esophageal injury and perforation due to esophageal endoscopic procedure. The authors have recently experienced three cases of iatrogenic esophageal perforation following diagnostic endoscopic procedure of the esophagus. We summarize the pervention, diagnostic and therapeutic strategies for iatrogenic perforation.