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World Journal of Gastroenterology 2006年第44期12卷 7213-7215页

作者： Ming-Yu Chang Ming-Ling Chang Chang-Teng Wu Division of Pediatric Critical Care and Emergency Medicine Chang Gung Children's Hospital Taoyuan Taiwan 333 China Department of Hepatogastroenterology Chang Gung Memorial Hospital Taoyuan Taiwan 333 China Division of Pediatric Critical Care and Emergency Medicine Chang Gung Children's Hospital Taoyuan Taiwan 333 Chang Gung University Taoyuan Taiwan 333 China

A seven-month-old infant was admitted to our hospital with a 1-wk history of shortness of breath, dysphagia, and fever. Diagnosis of esophageal perforation follow- ing fish vertebra ingestion was made by history review, pneumomediastinum and an irregular hyperdense lesion noted in initial chest radiogram. Neck computed tomo- graphy (CT) confirmed that the foreign body located at the cricopharyngeal level and a small esophageal tra- cheal fistula was shown by esophagogram. The initial re- sponse to treatment of fish bone removal guided by pan- endoscopy and antibiotics administration was poor since pneumothorax plus empyema developed. Fortunately, the patient’s condition finally improved after decortica- tion, mediastinotomy and perforated esophagus repair. To our knowledge, this is the first case report of esopha- geal perforation due to fish bone ingestion in infancy. In addition to particular caution that has to be taken when feeding the innocent, young victim, it may indicate the importance of surgical intervention for complicated esophageal perforation in infancy.

关键词： Fish bone esophageal perforation Mediastinitis Decortication Mediastinotomy

Routine nasogastric tube placement in patients with small esophageal perforation after endoscopic foreign body removal may be unnecessary:a propensity score matching analysis

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Gastroenterology Report 2023年第1期11卷 433-438页

作者： Foqiang Liao Qinyu Yang Zhenyi Zhan Zhenhua Zhu Xiaolin Pan Chong Wang Bimin Li Yin Zhu Youxiang Chen Xu Shu Department of Gastroenterology Digestive Disease HospitalThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxiP.R.China Jiangxi Clinical Research Center for Gastroenterology The First Affiliated Hospital of Nanchang UniversityNanchangJiangxiP.R.China

Background:Nasogastric tube(NGT)placement is part of the post-operative management of upper gastrointestinal perforation,but its routine use in esophageal perforation(EP)caused by foreign bodies remains *** purpose of this research was to investigate the necessity for routine NGT placement in patients with EP after endoscopic foreign body ***:A total of 323 patients diagnosed with EP caused by foreign bodies at the First Affiliated Hospital of Nanchang University between January 2012 and December 2021 were included in this retrospective *** were divided into the NGT group and the non-NGT group according to whether or not NGT placement was *** perforation healing rate,post-operative adverse events,hospital stay,and death rate were analysed using a 1:1 propensity score matching ***:Before matching,there were 263 patients in the NGT group and 60 patients in the non-NGT *** were significant differences in the time to treatment,infection,albumin,and types of endoscopy between the two groups,while the length of hospital stay in the NGT group was significantly longer than that in the non-NGT *** 1:1 propensity score matching,48 pairs of patients were matched between the two *** perforation healing rate,post-operative adverse events,length of hospital stay,and death rate did not show significant differences between the two ***:For patients with small EP caused by foreign bodies,routine NGT placement after endoscopic foreign body removal may be unnecessary.

关键词： esophageal perforation foreign body nasogastric tube placement propensity score matching

Bedside ultrasound-guided water injection assists endoscopically treatment in esophageal perforation caused by foreign bodies: A case report

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World Journal of Gastrointestinal Surgery 2023年第6期15卷 1240-1246页

作者： Hua-Xing Wei Song-Yong Lv Bin Xia Kai Zhang Chen-Ke Pan Department of Ultrasound The Fourth Affiliated Hospital of Zhejiang University College of MedicineYiwu 322200Zhejiang ProvinceChina Department of Ultrasound Jinyun County People’s HospitalLishui 321400Zhejiang ProvinceChina

BACKGROUND Fishbone migration from the esophagus to the neck is relatively uncommon in clinical *** complications secondary to esophageal perforation after ingestion of a fishbone have been described in the ***,a fishbone is detected and diagnosed by imaging examination and is usually removed by a neck *** SUMMARY Herein,we report a case of a 76-year-old patient with a fishbone in the neck that had migrated from the esophagus and that was in close proximity to the common carotid artery,and the patient experienced *** endoscopically-guided neck incision was made over the insertion point in the esophagus,but the surgery failed due to having a blurred image at the insertion site during the *** injection of normal saline laterally to the fishbone in the neck under ultrasound guidance,the purulent fluid outflowed to the piriform recess along the sinus *** endoscopic guidance,the position of the fish bone was precisely located along the direction of liquid outflow,the sinus tract was separated,and the fish bone was *** the best of our knowledge,this is the first case report describing bedside ultrasound-guided water injection positioning combined with endoscopy in the treatment of a cervical esophageal perforation with an *** In conclusion,the fishbone could be located by the water injection method under the guidance of ultrasound and could be accurately located along the outflow direction of the purulent fluid of the sinus by the endoscope and was removed by incising the *** method can be a nonoperative treatment option for foreign body-induced esophageal perforation.

关键词： esophageal perforation Foreign body removal Fishbone Beside ultrasound-guided Endoscopy Case report

Vertebral body infection due to esophageal perforation caused by ingestion of fishbone:a case report

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Frontiers of Nursing 2020年第2期7卷 77-79页

作者： Ling-Yun Zhang Hong Liang Xue-Guo Sun Department of Gastroenterology The Affiliated Hospital of Qingdao UniversityQingdaoShandong 266000China The Community Healthcare Center of Yan’an’er Road QingdaoShandong 266000China

Background:esophageal injury is a common complication of foreign bodies in the upper gastrointestinal tract,but bilateral pleural effusion or vertebral infection is a rare condition due to a swallowed *** is considerably difficult for a physician to diagnose quickly because of incomplete patient history of foreign bodies ingestion and/or insufficient *** concerns:We describe the case of a 56-year-old man who was admitted to an emergency medical department owing to a low to moderate fever for 7 *** a series of examinations,the patient was diagnosed with esophageal perforation(EP)caused by a fishbone that was swallowed half a month ***:About 12 days after the onset of fever,he was diagnosed with EP based on the gastric endoscopic images combined with histological section and sufficient history of the *** 2 months later,the patient has obvious back pain and lack of strength in two legs and was diagnosed with vertebral body ***:Antibiotic therapy,multi-disciplinary team(MDT),and surgical intervention had been ***:It is very fortunate for this patient to have a good prognosis due to a timely diagnosis and proper *** power has attained level ***:Several lessons can be learned from this case;for example,physicians should be alerted to the EP,endoscopic intervention should be prompt,antibiotics should be used regularly,and so on.

关键词： esophageal perforation spinal infection foreign body operation

A rare case of circumferential intramural dissection of thoracic esophagus with contained esophageal perforation

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Chinese Medical Journal 2011年第20期124卷 3433-3435页

作者： WANG Shao-hua RUAN Zheng LIU Fa-bing HUANG Hai-long ZHENG Jian SONG Kang-sheng Department of Thoracic Surgery the First Affiliated People＇sHospital Shanghai Jiao Tong University Shanghai 200080 China

In this report, a full account of an extremely rare case on esophageal intramural dissection （EID） is presented. A 56-year-old female patient, misdiagnosed as esophageal mediastinal fistula under endoscopic view, was diagnosed correctly as EID with contained esophageal perforation in the operation and cured by thoracic esophagectomy.

关键词： esophageal intramural dissection esophageal perforation esophagectomy

A Case of esophageal perforation Presenting as Cavitary Pneumonia: Diagnostic and Therapeutic Challenges

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Open Journal of Gastroenterology 2024年第7期14卷 241-247页

作者： Feruza Abraamyan Harpreet Singh Vishal Raj Inder M. Singh Internal Medicine Department Sutter Roseville Medical Center Roseville CA USA Pulmonary Medicine Associates Sutter Roseville Medical Center Roseville CA USA Gastroenterology Department Sutter Roseville Medical Center Roseville CA USA

esophageal perforation, a rare condition, can arise from iatrogenic, traumatic, or spontaneous origins. Even when therapy is initiated within the first 24 hours, it is associated with a mortality rate of up to 25%. Due to the varied initial presentation, treatment may be delayed, leading to poorer outcomes. Here, we present a unique case of a 27-year-old schizophrenic patient who initially presented with acute respiratory failure and septic shock and was ultimately diagnosed with cavitary pneumonia secondary to esophageal perforation.

关键词： esophageal perforation Foreign Body esophageal Stent Cavitary Pneumonia Septic Shock Respiratory Failure

predictors for failure of stent treatment for benign esophageal perforations- a single center 10-year experience

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World Journal of Gastroenterology 2014年第30期20卷 10613-10619页

作者： Saga Persson Peter Elbe Ioannis Rouvelas Mats Lindblad Koshi Kumagai Lars Lundell Magnus Nilsson Jon A Tsai Division of Surgery Karolinska Institutet and GastroCentrumDepartment of Clinical SciencesIntervention and TechnologyKarolinska University Hospital Huddinge141 86 StockholmSweden

AIM: To investigate possible predictors for failed self-expandable metallic stent (SEMS) therapy in consecutive patients with benign esophageal perforation-rupture (EPR).

关键词： esophageal perforation Stents Esophagectomy Morbidity Mortality Mediastinitis

Surgical Treatment of perforation with esophageal Carcinoma

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Chinese Journal of Clinical Oncology 2006年第2期3卷 126-129页

作者： Depu Duan Jihua Zou Zhinang Cai Shengyong Wu Haibo Xiao Yiyong Zhou Xiang Liang Dekui Sun Songchang Wu Department of Cardiothoracic Surgery of No.455 Hospital of the PLA.Academic Center of Thoracic Surgery of the Nanjing Military Region Shanghai 200052China

OBJECTIVE To determine the ideal method of surgical preoperative treatment for perforation with esophageal carcinoma.METHODS 36 cases of perforation with esophageal carcinoma were treated surgically in this *** occurred into the right lung in 14 *** mediastinum in 17 cases and treachea in 5 *** thoracic surgery was performed in 34 *** which the right thoracic approach using a 3-incision method was applied in 16 cases,and operation by stages in 15 *** the 34 *** substitution of the esophagus with stomach or colon was performed in 26 cases.RESULTS Surgery was successful in 31 cases and operative death occurred in 3 *** postoperative follow up study was from 3-72 *** these cases 15 were alive 15 7-12 months,2 at 24 *** 1 at 72 *** results can be considered satisfactory.CONCLUSION The therapeutic results of surgical treatment of perforation with esophageeal carcinoma were markedly superior to that of conventional conservative *** authors suggest that surgical interventionwithout delay should be undertaken for patients having a perforation with carcinoma of the esophagus.A right thoracic approach with a 3-incision method（retrosternal replacement of esophagus with stomach or colon0or operation by stages is preferable.

关键词： esophageal neoplasm esophageal perforation surgery

Severe esophageal injury after radiofrequency ablation-a deadly complication

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World Journal of Gastroenterology 2017年第18期23卷 3374-3378页

作者： Nurit Katz-Agranov Moises I Nevah Rubin Department of Internal Medicine The University of Texas Health Science Center at Houston Department of Gastroenterology Hepatology and Nutrition the University of Texas Health Science Center at Houston

Various degrees of esophageal injury have been described after radiofrequency ablation performed for treatment of atrial fibrillation. The main mechanism of injury is thermal and may lead to a range of esophageal mucosal changes, some clinically insignificant, however when deep ulceration occurs, this may be further complicated by perforation and mediastinitis, a rare but life threatening sequelae. We present a case of a severe esophageal injury leading to mediastinitis, with interesting endoscopic findings.

关键词： Atrial fibrillation Radiofrequency ablation esophageal perforation Ulceration Mediastinitis

False esophageal hiatus hernia caused by a foreign body: A fatal event

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World Journal of Gastroenterology 2014年第39期20卷 14510-14514页

作者： Ya-Ping Lu Ming Yao Xu-Yan Zhou Bing Huang Wei-Bo Qi Zhi-Heng Chen Long-Sheng Xu Department of Anesthesiology First Affiliated Hospital of Jiaxing University Department of Cardiothoracic Surgery First Affiliated Hospital of Jiaxing University Department of Gastrointestinal Surgery First Affiliated Hospital of Jiaxing University Department of Special Inspection First Affiliated Hospital of Jiaxing University

Foreign body ingestion is a common complaint in gastrointestinal clinics. It is usually not difficult to diagnose because most of the patients report a definitive history of accidental foreign body ingestion. However, in rare cases, patients do not have a clear history. Thus, the actual condition of the patient is difficult to diagnosis or is misdiagnosed; consequently, treatment is delayed or the wrong treatment is administered, respectively. This report describes a fatal case of esophageal perforation caused by an unknowingly ingested fishbone, which resulted in lower esophageal necrosis, chest cavity infection, posterior mediastinum fester, and significant upper gastrointestinal accumulation of blood. However, his clinical symptoms and imaging data are very similar with esophageal hiatal hernia. Unfortunately, because the patient was too late in consulting a physician, he finally died of chest infection and hemorrhage caused by thoracic aortic rupture. First, this case report underlines the importance of immediate consultation with a physician as soon as symptoms are experienced so as not to delay diagnosis and treatment, and thus avoid a fatal outcome. Second, diagnostic imaging should be performed in the early stage, without interference by clinical judgment. Third, when computed tomography reveals esophageal hiatus hernia with stomach incarceration, posterior mediastinal hematoma, and pneumatosis caused by esophageal, a foreign body should be suspected. Finally, medical professionals are responsible for making people aware of the danger of foreign body ingestion, especially among children, those who abuse alcohol, and those who wear dentures, particularly among the elderly, whose discriminability of foreign bodies is decreased, to avoid dire consequences.

关键词： esophageal hiatus hernia Foreign body esophageal perforation Gastrointestinal accumulation