An unusual case of spontaneous esophagopleural fistula

Dash, Manoranjan; Mohanty, Thitta; Patnaik, Jyoti; Mishra, Narayan; Subhankar, Saswat; Parida, Priyadarsini

doi:10.4103/0970-2113.205327

Cited by 5 publications

(7 citation statements)

References 6 publications

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“…Esophago-pleural fistula commonly occurs on the right side of the chest since the esophagus is in closer contact with the pleura on the right side. 4 Our patient had chronic alcohol abuse, which can pre-dispose to esophageal mucosal tears secondary to repeated bouts of vomiting, a condition called Mallory Weiss syndrome. MW tear is a longitudinal laceration of the esophageal mucosa, but it can lead to full-thickness perforation with repeat triggers.…”

Section: Discussionmentioning

confidence: 92%

A Case of Candida Empyema in a patient with Esophagopleural fistula

Alyacoub¹

2023

Journal of Community Hospital Internal Medicine Perspectives

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Fungal empyema is a rare entity, particularly in immunocompetent patients. It has been noted to occur in a patient with esophageal perforation. Esophageal perforation has a wide range of clinical presentations and associated complications depending on the size and site of perforation. Although the classic presentation of esophageal perforation, also known as Boerhaave syndrome, is often dramatic with hemodynamic instability and mediastinitis. Smaller perforations and esophageopleural fistula can lead to more indolent presentation in the form of complications such as necrotizing pneumonia and pleural effusions. Here we present a 42-year-old patient with alcohol withdrawal and aspiration pneumonia, later found to have loculated pleural effusions and empyema with pleural culture growing candida and staph Epidermidis. After his mental recovery, the initiation of oral feeding led to the discovery of esophageal perforation, further complicated by esophageopleural fistula formation. He had a prolonged hospital course but remained hemodynamically stable. He was treated with an esophageal stent and feeding tube placement, as well as antifungals for candida empyema.

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Section: Discussionmentioning

confidence: 92%

A Case of Candida Empyema in a patient with Esophagopleural fistula

Alyacoub¹

2023

Journal of Community Hospital Internal Medicine Perspectives

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“…A disproportionately high proportion of males affected is also one of the consistent findings across the studies. In some studies, the proportion of males was marginally higher, 16 but the majority of the studies have reported the proportion of males to be between 60 and 70%. 17 – 21 It is crucial to consider the social and cultural factors that may impact gender differences.…”

Section: Discussionmentioning

confidence: 97%

Determinants of Poison-related Mortality in Tertiary Care Hospital, South India

Ramesh,

Krishnasamy,

Narmadhalakshmi

et al. 2024

Indian Journal of Critical Care Medicine

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Aims and background Acute poisoning is one of the most common emergencies in India and around the world. Understanding the factors associated with mortality can aid us in devising appropriate preventive strategies to curtail deaths due to poisoning. Purpose of this study is to find various factors that determine the mortality among acute poisoning cases admitted in a tertiary care center. Materials and methods A retrospective hospital records-based study was conducted at Chengalpattu Medical College Hospital. The study included 2,123 cases of various poisoning cases admitted for a year from January to December 2022. Cases of bites, stings, drowning, and hanging were excluded. Information on sociodemographic profile, type of poison, time since ingestion and admission, and treatment outcome were collected using a structured pro forma. Results The mean age of the study population was 29.90 ± 14.98 years. Poisoning was found to be predominantly among males (56.42%) and residents of rural areas (58%). Insecticide consumption (27.0%) was the most common modality, followed by oleander poisoning (20%), corrosive poison (17%), rat poison (15%), tablet poison (13%), and other poisons. The overall case fatality rate (CFR) was 5.2%, with the highest CFR of 12.25% with insecticide poisoning. In multivariate analysis, Glasgow coma scale (GCS) score at admission is the only parameter showing a statistically significant association with mortality (adjusted odds-ratio 0.271(0.2–0.38, p -value < 0.01). Conclusion Acute poisoning primarily affects the young and economically productive population. In the south Indian population, pesticides are still the major contributor though corrosives are a major contributor among children. Mortality is still significant, and GCS status admission is the only predictor of mortality. How to cite this article Krishnasamy N, Narmadhalakshmi R, Parameshwari P, Jayalakshmi R, Lokesh R, Jayanthi R, et al . Determinants of Poison-related Mortality in Tertiary Care Hospital, South India. Indian J Crit Care Med 2024;28(4):329–335.

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“…2 Given the nonspecific findings of EPF, a high degree of suspicion is warranted, particularly if fever, dyspnea, and hypoxia are identified in the setting of a recent esophageal procedure. 1 Because of recurrent variceal hemorrhage refractory to repeated banding, our patient with Child-Pugh B cirrhosis and MELD-Na 13 underwent Minnesota tube placement as a bridge therapy to a planned transjugular intrahepatic portosystemic shunt. Before balloon placement, the patient had no definable stigmata of esophageal injury.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…An esophagopleural fistula (EPF) is a rare condition characterized by an abnormal connection between the esophagus and the pleural space due to an esophageal perforation or tumor invasion. 1,2 Some of the etiologies include prior pneumonectomy, esophageal foreign body, and sequelae related to malignancies of the esophagus, lung, and mediastinum. 2,3 Clinical manifestations are nonspecific and include fever, subcutaneous emphysema, dyspnea, and pleural effusions.…”

Section: Introductionmentioning

confidence: 99%

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Iatrogenic Esophagopleural Fistula After the Management of Acute Variceal Hemorrhage With Minnesota Tube Placement

et al. 2021

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An esophagopleural fistula (EPF) is a rare condition. EPFs are typically of spontaneous, iatrogenic, or neoplastic origin. A 50-year-old man with hepatitis C and alcoholic cirrhosis presented with a history of recurrent variceal hemorrhage requiring esophageal banding, Minnesota tube placement, and a transjugular intrahepatic portosystemic shunt. His hospital course after esophageal perforation and EPF was complicated by acute respiratory failure and empyema, necessitating intubation and thoracostomy tube placement. To the best of our knowledge, this is the first reported case of EPF secondary to Minnesota tube placement. The EPF completely healed after endoscopic repair.

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An unusual case of spontaneous esophagopleural fistula

Cited by 5 publications

References 6 publications

A Case of Candida Empyema in a patient with Esophagopleural fistula

A Case of Candida Empyema in a patient with Esophagopleural fistula

Determinants of Poison-related Mortality in Tertiary Care Hospital, South India

Iatrogenic Esophagopleural Fistula After the Management of Acute Variceal Hemorrhage With Minnesota Tube Placement

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