CT scan findings in oesophagogastric perforation after out of hospital cardiopulmonary resuscitation

Sajith, A; O'Donohue, B; Roth, Roland; Khan, Rana

doi:10.1136/emj.2006.044008

Cited by 12 publications

(2 citation statements)

References 8 publications

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“…Computer tomography (CT) of the chest and upper abdomen with oral contrast can also show whether there is a leak [30](Figure 2). In addition, collection of air or fluid in the mediastinum, pleural effusions, pneumocardium and pneumoperitoneum are important diagnostic findings in these patients [31-33].…”

Section: Introductionmentioning

confidence: 99%

Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours

Søreide

Viste

2011

Scand J Trauma Resusc Emerg Med

207

183

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Esophageal perforation is a rare and potentially life-threatening condition. Early clinical suspicion and imaging is important for case management to achieve a good outcome. However, recent studies continue to report high morbidity and mortality greater than 20% from esophageal perforation. At least half of the perforations are iatrogenic, mostly related to endoscopic instrumentation used in the upper gastrointestinal tract, while about a third are spontaneous perforations. Surgical treatment remains an important option for many patients, but a non-operative approach, with or without use of an endoscopic stent or placement of internal or external drains, should be considered when the clinical situation allows for a less invasive approach. The rarity of this emergency makes it difficult for a physician to obtain extensive individual clinical experience; it is also challenging to obtain firm scientific evidence that informs patient management and clinical decision-making. Improved attention to non-specific symptoms and signs and early diagnosis based on imaging may translate into better outcomes for this group of patients, many of whom are elderly with significant comorbidity.

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Section: Introductionmentioning

confidence: 99%

Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours

Søreide

Viste

2011

Scand J Trauma Resusc Emerg Med

207

183

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“…This combined with the force provided by chest compressions may lead to perforation of the stomach. Thus far, Sajith et al have described the only case of gastric perforation after CPR using the LUCAS device [14]. …”

Section: Discussionmentioning

confidence: 99%

Complications of mechanical chest compression devices

Platenkamp

Otterspoor

2013

Neth Heart J

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Endoscopic Management of Benign Esophageal Ruptures and Leaks

Leo

Maselli

Ferrara

et al. 2017

Curr Treat Options Gastro

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Esophageal leaks (EL) and ruptures (ER) are rare conditions associated with a high risk of mortality and morbidity. Historically, EL and ER have been surgically treated, but current treatment options also include conservative management and endoscopy. Over the last decades, interventional endoscopy has evolved as an effective and less invasive alternative to primary surgery in these cases. A variety of techniques are currently available to re-establish the continuity of the digestive tract, prevent or treat infection related to the leak/rupture, prevent further contamination, drain potential collections, and provide nutritional support. Endoscopic options include clips, both through the scope (TTS) and over the scope (OTS), stent placement, vacuum therapy, tissue adhesive, and endoscopic suturing techniques. Theoretically, all of these can be used alone or with a multimodality approach. Endoscopic therapy should be combined with medical therapy but also with percutaneous drainage of collections, where present. There is robust evidence suggesting that this change of therapeutic paradigm in the form of endoscopic therapy is associated with improved outcome, better quality of life, and shortened length of hospital stay. Moreover, recent European guidelines on endoscopic management of iatrogenic perforation have strengthened and to some degree regulated and redefined the role of endoscopy in the management of conditions where there is a breach in the continuity of the GI wall. Certainly, due to the complexity of these conditions and the variety of available treatment options, a multidisciplinary approach is strongly recommended, with close clinical monitoring (by endoscopists, surgeons, and intensive care physicians) and special attention to signs of sepsis, which can lead to the need for urgent surgical management. This review article will critically discuss the literature regarding endoscopic modalities for esophageal leak and perforation management and attempt to place them in perspective for the physician.

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CT scan findings in oesophagogastric perforation after out of hospital cardiopulmonary resuscitation

Cited by 12 publications

References 8 publications

Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours

Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours

Complications of mechanical chest compression devices

Endoscopic Management of Benign Esophageal Ruptures and Leaks

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