A black perforated esophagus treated with surgery: Report of a case

Abstract

A case of a perforated black esophagus treated with minimal invasive surgery is presented. A 68-year-old women underwent a right-sided hemihepatectomy and radio frequency ablation of two metastasis in the left liver lobe. Previous history revealed a hemicolectomy for an obstructive colon carcinoma with post-operative chemotherapy. Postoperatively she developed severe dyspnea due to a perforation of the esophagus with leakage to the pleural space. Video-assisted thoracoscopic surgery (VATS) to adequately drain the perforation was performed. Gastroscopy revealed a perforated black esophagus. The black esophagus, acute esophageal necrosis or Gurvits syndrome is a rare entity with an unknown aetiology which is likely to be multifactorial. The estimated mortality rate is high. To our knowledge, this is the first case published of early VATS used in a case of perforated black esophagus.

Acute esophageal necrosis with esophagus perforation treated by thoracoscopic subtotal esophagectomy and reconstructive surgery on a secondary esophageal stricture: a case report

“…Primary closure of the perforated esophageal tissue or primary reconstruction should not be attempted because saving the life of the patient should take priority at this point [11]. Six patients with perforated AEN undergone surgical intervention on literature review [2, 12]. One case involved a thoracoscopic approach placing an intrathoracic flushing system drain near the perforation [12].…”

“…Six patients with perforated AEN undergone surgical intervention on literature review [2, 12]. One case involved a thoracoscopic approach placing an intrathoracic flushing system drain near the perforation [12]. However, in this case, the esophagus appeared normal from the outside, suggesting that there was no transmural necrosis of the esophagus [12].…”

“…One case involved a thoracoscopic approach placing an intrathoracic flushing system drain near the perforation [12]. However, in this case, the esophagus appeared normal from the outside, suggesting that there was no transmural necrosis of the esophagus [12]. The other cases involved an open approach.…”

“…Esophageal stricture is a complication in the chronic phase of AEN. When reviewing literature, 20 of 164 patients progressed to esophageal stricture within 3 weeks to 2 months after the onset of AEN [8, 12–20]. The initial treatment in most AEN-induced stricture cases was endoscopic balloon dilation (EBD).…”

Comprehensive review of acute oesophageal necrosis

“…Of these cases, we managed to extract data from 79 articles having 105 cases of AON (online supplementary table 1). 5–82 Data could not be extracted from (n=13) of the articles containing a total of (n=20) cases 4 83–95. The most common reasons for these were unavailability of complete data or the language being other than English.…”