5.Esophageal Perforation after Anterior Cervical Spine Surgery
Sang Bong KO ; Jong Beom PARK ; Kyung Jin SONG ; Dong Ho LEE ; Seong Wan KIM ; Young Yul KIM ; Taek Soo JEON ; Yoon Joo CHO
Asian Spine Journal 2019;13(6):976-983
STUDY DESIGN: Retrospective case analyses.PURPOSE: To investigate the causes, diagnosis, and management of esophageal perforation, depending on the time of diagnosis.OVERVIEW OF LITERATURE: To date, few studies have addressed these issues.METHODS: A total of seven patients were included in this study. The patients were classified into three groups based on esophageal perforation diagnosis time: intraoperative (diagnosed during surgery), perioperative (diagnosed within 30 days postoperatively), and delayed (diagnosed >30 days postoperatively) groups.RESULTS: In the intraoperative group (N=2), infectious spondylitis was the main cause of esophageal perforation. Anterior plate and screw removal, followed by posterior instrumentation, was performed. The injured esophagus was managed by omentum flap repair in one patient and primary repair in one patient. In the perioperative group (N=2), revision surgery for infection and metal failure were the main causes of esophageal perforation. In both cases, food residue was drained on the third postoperative day. The injured esophagus was managed conservatively. In the delayed group (N=3), chronic irritation caused by metal failure was the main cause of esophageal perforation. In all patients, there was no associated infection. The anterior instrumentation was removed, and the two patients were treated by primary repair, and one patient was treated using sternocleidomastoid muscle flap. One patient in intraoperative group died of sepsis.CONCLUSIONS: The main cause of intraoperative esophageal perforation was esophageal adhesions because of infectious spondylitis. However, perioperative and delayed esophageal perforations were caused by chronic irritation because of metal failure. Anterior plate and screw removal was necessary, and posterior instrumentation and fusion may be considered, depending on the fusion status.
Diagnosis
;
Esophageal Perforation
;
Esophagus
;
Humans
;
Omentum
;
Retrospective Studies
;
Sepsis
;
Spine
;
Spondylitis
6.Risk factors predicting development of complications in 72 dogs with esophageal foreign bodies
Bohye SHIN ; Hakhyun KIM ; Dongwoo CHANG ; Ji Houn KANG ; Byeong Teck KANG ; Mhan pyo YANG
Korean Journal of Veterinary Research 2019;59(1):25-31
The aim of this study was to determine predictive risk factors implicated in complications in dogs with esophageal foreign bodies. Medical records of 72 dogs diagnosed with esophageal foreign bodies by endoscopy were reviewed retrospectively. Factors analyzed included age; breed; gender; body weight, location, dimension, and type of foreign body; and duration of impaction. To identify risk factors associated with complications after foreign body ingestion, categorical variables were analyzed using the chi-square or Fisher's exact tests and multivariate analysis, as appropriate. Complications secondary to esophageal foreign body ingestion included megaesophagus, esophagitis, perforation, laceration, diverticulum, and pleuritis. Univariate analysis revealed that the location and duration of impaction after foreign body ingestion were associated with an increased risk of esophageal laceration and perforation. Multivariate analysis showed that age, duration of impaction, and foreign body dimension were significant independent risk factors associated with the development of complications in dogs with esophageal foreign bodies. In conclusion, these results showed that longer duration of impaction and larger foreign body dimensions may increase the risks of esophageal laceration, perforation, and plueritis in dogs.
Animals
;
Body Weight
;
Diverticulum
;
Diverticulum, Esophageal
;
Dogs
;
Eating
;
Endoscopy
;
Esophageal Achalasia
;
Esophageal Perforation
;
Esophagitis
;
Foreign Bodies
;
Lacerations
;
Medical Records
;
Multivariate Analysis
;
Pleurisy
;
Retrospective Studies
;
Risk Factors
7.Successful Treatment Using Endoluminal Vacuum Therapy after Failure of Primary Closure in Boerhaave Syndrome
Young Eun KIM ; Young Woo DO ; Joon Yong CHO ; Eun Soo KIM ; Deok Heon LEE
The Korean Journal of Gastroenterology 2019;73(4):219-224
Boerhaave syndrome is a transmural perforation of the esophagus and typically occurs after forceful emesis. Boerhaave syndrome is a destructive disease with a high mortality rate, though surgical intervention within 24 hours has a beneficial effect. On the other hand, late surgical intervention is associated with poorer prognoses. Several therapeutic strategies, ranging from medical to surgical management, are available for Boerhaave syndrome. Recently, endoscopic endoluminal vacuum therapy (EVT) was introduced as a treatment option. Here, we report the case of a 56-year-old male patient with Boerhaave syndrome who was successfully treated by EVT after primary closure failure. The patient recovered without complication.
Endoscopy
;
Esophageal Perforation
;
Esophagus
;
Hand
;
Humans
;
Male
;
Middle Aged
;
Mortality
;
Prognosis
;
Vacuum
;
Vomiting
8.Esophageal perforation in children: etiology and management, with special reference to endoscopic esophageal perforation.
Korean Journal of Pediatrics 2018;61(6):175-179
Perforation of the esophagus is an uncommon problem with significant morbidity and mortality. In children undergoing endoscopy, the risk of perforation is higher when interventional endoscopy is performed. The clinical features depend upon the site of esophageal perforation. Opinions vary regarding the optimal treatment protocol, and the role of conservative management in this context is not well established. Esophageal perforation that occurs as a consequence of endoscopy in children requires careful evaluation and management, as outlined in this article.
Child*
;
Clinical Protocols
;
Endoscopy
;
Esophageal Perforation*
;
Esophagoscopy
;
Esophagus
;
Foreign Bodies
;
Humans
;
Mortality
9.Esophageal Foreign Body: Treatment and Complications.
The Korean Journal of Gastroenterology 2018;72(1):1-5
The most common cause of esophageal foreign bodies in adults is meat in Western countries and fish bones in Asian countries, including Korea. Although most ingested foreign bodies pass spontaneously through the esophagus without any clinical sequelae, some sharp foreign bodies, such as fish bones embedded in the esophagus, require treatment. Endoscopic management is the first choice in the treatment of esophageal foreign bodies because it is quite safe and effective. Major complications occur as a result of esophageal perforation; in particular, sharp foreign bodies, such as fish bones, are more likely to cause perforation. Complications include mediastinitis, paraesophageal abscess, pneumomediastinum, subcutaneous emphysema, pneumothorax, tracheoesophagal fistula, aortoesophageal fistula, aspiration, and asphyxia. Unnecessary delays should be avoided in endoscopic intervention for esophageal foreign bodies to prevent complications.
Abscess
;
Adult
;
Asian Continental Ancestry Group
;
Asphyxia
;
Esophageal Perforation
;
Esophagus
;
Fistula
;
Foreign Bodies*
;
Humans
;
Korea
;
Meat
;
Mediastinal Emphysema
;
Mediastinitis
;
Pneumothorax
;
Subcutaneous Emphysema
10.Mallory-Weiss Tear After Cardiopulmonary Resuscitation in a Patient Suffering From Acute Myocardial Infarction.
Jin Seok YU ; Woo Suk KO ; June Hyun KIM ; Kwang Uk BAE
Kosin Medical Journal 2018;33(2):235-239
A report of a 79 year old male patient suffering from acute myocardial infarction with Mallory-Weiss tear after successful cardiopulmonary resuscitation(CPR) by emergency medical technician in the swimming pool is presented. Successful percutaneous coronary intervention(PCI) was done after appropriate transfusion. The patient survived and discharged without major complications after admitting 11days in the hospital. Importance of CPR in AMI patient is reiterated as complication such as Mallory-Weiss tear may arise.
Cardiopulmonary Resuscitation*
;
Emergency Medical Technicians
;
Humans
;
Male
;
Mallory-Weiss Syndrome*
;
Myocardial Infarction*
;
Swimming Pools

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