Emergency endoscopic negative pressure therapy of a long oesophageal perforation in eosinophilic esophagitis with a single-lumen nasogastric tube-like open-pore film drain

Loske, Gunnar; Scharsack, Ernst; Gobrecht, Olaf

doi:10.1055/a-1493-1805

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…[9] Open-pore polyurethane foam drains with long drainage elements were used to cover the long perforation defect, and the contaminated wound secretion and liquid digestive tract were extracted under intraluminal endoscopic negative pressure. [10] ENPT combined with surgery, such as laparotomy with abdominal lavage, has also been suggested in a complementary manner, [9] thus directly contributing to wound healing. Customized patient treatment depends on the patients' condition, lesion extension and time from symptom onset.…”

Section: Discussionmentioning

confidence: 99%

Occurrence of Boerhaave’s syndrome after diagnostic colonoscopy: what else can emergency physicians do?

Zhu¹,

Lyu²,

Lei³

et al. 2023

World Journal of Emergency Medicine

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Boerhaave's syndrome is a barogenic tear of the esophagus, typically at the gastroesophageal junction, caused by a sudden increase in intraluminal pressure in the distal esophagus. [1] In recent years, the number of Boerhaave's syndrome cases has increased, and a growing proportion of clinicians have recognized this rare but life-threatening disease. Untimely diagnosed patients showed a significant association with high mortality, which was >56% after 24 h and 75%-89% after 48 h. [2] Emergency physicians play a critical role in the early rapid detection and diagnosis of Boerhaave's syndrome by arranging reasonable examinations and developing a multidisciplinary team. Herein, we report a case from China of a patient who developed spontaneous esophageal rupture during diagnostic colonoscopy. We aim to determine the optimal management strategies for Boerhaave's syndrome from an emergency physician's perspective.

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Section: Discussionmentioning

confidence: 99%

Occurrence of Boerhaave’s syndrome after diagnostic colonoscopy: what else can emergency physicians do?

Zhu¹,

Lyu²,

Lei³

et al. 2023

World Journal of Emergency Medicine

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“…Thus, owing to the availability of thin open-pore drainage films, the use of which to our best knowledge has not been yet described in infants, EVT becomes technically feasible even in very young infants with small esophageal diameters. However, from our own and other authors’ experience in adults, EVT sponges adhere more strongly to the tissue and for this reason exert higher debriding properties than EVT films, inducing more granulation and eliminating necroses more efficiently [ 29 ]. In older wounds containing a lot of debris (like in cases “1” and “2” described here) it is therefore desirable to switch to EVT sponges if technically possible.…”

Section: Discussionmentioning

confidence: 99%

Management of esophageal perforations in infants by endoscopic vacuum therapy: a single center case series

et al. 2022

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Background Endoscopic vacuum therapy (EVT) has become a standard treatment method for esophageal perforations in adults. However, experience with EVT in infants is scarce. In this retrospective case series, we report on four very young infants who were successfully treated with EVT for esophageal perforations of different etiology. Methods Four infants were diagnosed with esophageal perforations on day 7, 32, 35 and 159 of life, respectively. The youngest one was prematurely born in the 31st week of pregnancy weighing 980 g only. Three infants had perforations due to foreign body insertion (nasogastric tube or pulling through of percutaneous endoscopic gastrostomy (PEG) tube through the esophagus). One child had an anastomotic dehiscence after Foker’s surgery for atresia. In three children EVT was applied as first-line therapy for perforation, in one child EVT was a rescue therapy due to persisting leakage after surgical closure involving thoracotomy. Depending on the esophageal diameter, either an open-pore drainage film or polyurethane sponge was attached to a single-lumen 8 Fr suction catheter, endoscopically (or fluoroscopically by wire-guidance) placed into the esophagus (intraluminal EVT) and supplied with continuous negative pressure (ranging between 75 and 150 mmHg). The EVT system was exchanged twice per week. Results Complete closure of the perforation/leakage could be achieved in all four infants (100%) after 22 days of continuous EVT (median value; range 7–39) and 4.5 EVT exchanges (median value; range 1–12). No serious adverse events occurred. Conclusions EVT is an effective and safe addition to our therapeutic armamentarium in the management of esophageal perforations irrespective of its etiology. Here we prove the feasibility of EVT even in very young infants. The use of an extra thin vacuum open-pore drainage film is helpful to cope with the small esophageal diameter. EVT settings and exchange rates similar to those known from adult treatment were used.

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Emergency endoscopic negative pressure therapy of a long oesophageal perforation in eosinophilic esophagitis with a single-lumen nasogastric tube-like open-pore film drain

Cited by 2 publications

References 6 publications

Occurrence of Boerhaave’s syndrome after diagnostic colonoscopy: what else can emergency physicians do?

Occurrence of Boerhaave’s syndrome after diagnostic colonoscopy: what else can emergency physicians do?

Management of esophageal perforations in infants by endoscopic vacuum therapy: a single center case series

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