Endoscopic Intraluminal Drainage: An Alternative Treatment for Phlegmonous Esophagitis

Kim, Jong Won; Ahn, Hyo Yeong; Kim, Gwang Ha; Kim, Yeong‐Dae; Hoseok,; Cho, Jeong Su

doi:10.5090/kjtcs.2019.52.3.165

Cited by 7 publications

(3 citation statements)

References 5 publications

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“…Therefore, it has recently been spotlighted as an effective treatment for patients who cannot tolerate general anesthesia or who are concerned about complications after surgery. 3,5 However, extensive mucosal damage to the esophagus induced by endoscopic drainage can stimulate the overproduction of fibrous tissue, leading to complications such as esophageal stricture. 6 Esophageal stricture is an abnormal narrowing of the esophagus lumen and is a disease with a low prevalence of 1.1 per 10,000 person-years, but with significant adverse effects in affected patients.…”

Section: Discussionmentioning

confidence: 99%

Esophageal Stricture after Endoscopic Drainage of Esophageal Abscess as a Complication of Acute Phlegmonous Esophagitis: A Case Report

Kim

Ryu

Park

et al. 2022

Korean J Gastroenterol

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Esophageal abscess caused by acute phlegmonous esophagitis is rare but life-threatening. Rapid abscess drainage is an important part of the treatment, and endoscope-assisted intra-luminal abscess drainage is frequently performed. Although endoscopic drainage is less invasive than surgery, it has the potential to cause esophageal stricture as a complication. We present a rare case of esophageal stricture as a complication of intra-luminal drainage and evaluate a method to minimize the incidence of esophageal stricture complications.

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Section: Discussionmentioning

confidence: 99%

Esophageal Stricture after Endoscopic Drainage of Esophageal Abscess as a Complication of Acute Phlegmonous Esophagitis: A Case Report

Kim

Ryu

Park

et al. 2022

Korean J Gastroenterol

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“…Most abscesses can drain into the oesophageal cavity by themselves, but sometimes needle aspiration of pus or drainage of the abscess is required under gastroscopy. If the lesion involves the mediastinum and the adjacent organs to form a fistula, conservative medical treatment alone may be ineffective and surgical fistula repair or oesophagectomy might be required[ 1 , 5 ]. In addition to the primary treatment measures of elimination of predisposing factors and proper antibiotic selection and application[ 1 , 2 ], attention must be paid to nutritional support, postural drainage, and other symptomatic treatments at the same time.…”

Section: Discussionmentioning

confidence: 99%

Acute suppurative oesophagitis with fever and cough: A case report

Men

Singh

Zhang

et al. 2020

WJCC

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BACKGROUND Suppurative oesophagitis is a diffuse inflammation of the oesophagus characterized by suppurative exudate or pus formation. Suppurative infections can affect any part of the gastrointestinal tract, most commonly the stomach, with inflammation involving the entire gastric cavity. However, cases extending beyond the cardia or pylorus and involving the oesophagus, small intestine, and colon are rare. Usually such cases are discovered during surgery or autopsy. CASE SUMMARY We report a rare case of acute suppurative oesophagitis. A 57-year-old man presented at the Emergency Department of our hospital with fever and productive cough. The patient had a significant history of lower oesophageal mucosal frostbite. He was successfully diagnosed and treated with repeated gastroscopy, appropriate antibiotics, and innovative symptomatic treatment. CONCLUSION Early diagnosis and appropriate treatment of acute suppurative oesophagitis are critical. Nutritional support, postural drainage, and other symptomatic treatments must be considered.

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“…Before treatment of acute phlegmonous esophagitis, an esophageal examination (endoscopic and/or by contrast esophagogram) is mandatory to exclude esophageal perforation and confirm the integrity of muscular and serosa layers [9]. In cases of phlegmonous esophagitis, both medical and surgical interventions are described, the former for cases without an abscess; in other cases, if an spontaneous and effective pus drainage is not possible, a continuous internal drainage should be provided, in order to promote the reduction of abscess cavity size and speed the healing process; recently, some cases of endoscopic drainage were described, with the advantages of being a lesser invasive procedures with reduction of post-procedure complications [10]. In our case, due to uncertainly time of injury pro- gression, the budging of esophageal and gastric walls, suggesting an underlying inflammatory/infectious entity and the high perioperative risk of patient for surgery, the internal esophageal drainage was considered the best option.…”

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confidence: 99%

New Endoscopic Solutions in Managing Phlegmonous Esophagitis

Santos

Santos-Antunes

Morais

et al. 2022

Dig Dis

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A 48-years-old woman was admitted in the emergency department due epigastric pain, vomiting and cough. She presented with fever and increased inflammatory parameters. A thoracoabdominal computed-tomography (CT) was performed and revealed thickening of the gastric fundus and esophagus, with an apparent laceration in esophageal mucosa and associated dissection of esophageal wall. In upper endoscopy (UE), a bulging of esophageal and gastric walls was observed, with an ulceration in proximal esophagus, suggestive of a perforation. After multidisciplinary discussion, a minimally invasive endoscopic approach was decided. Internal esophageal drainage (IED) was assured with performance of some incisions with Dual-knife® (Olympus,Tokyo) along the mucosal and submucosal layers in the esophagus. During the incision, extravasation of pus was evident. One week later, due to clinical worsening and evidence of esophageal perforation in CT scan, UE was repeated. We confirmed esophageal perforation with visualization of two millimetric defects in the proximal esophagus. Significant bulging of the gastric fundus and body was also observed. IED was repeated with mucosal incision of the gastric bulging using Needle-Cut 3V® (Olympus, Tokyo), with extravasation of a significant quantity of pus. We decided to proceed to endoscopic vacuum therapy was performed with sponge placement in the esophageal lumen (Endosponge®, B.Braun,Melsungen,Germany). UE was repeated one week later with sponge removal and confirmation of resolution of esophageal perforation. An improvement of the thickening of gastric fundus and body was also seen. One month after admission, the patient was discharged home, eating normally, and remains well in the follow-up.

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Endoscopic Intraluminal Drainage: An Alternative Treatment for Phlegmonous Esophagitis

Cited by 7 publications

References 5 publications

Esophageal Stricture after Endoscopic Drainage of Esophageal Abscess as a Complication of Acute Phlegmonous Esophagitis: A Case Report

Esophageal Stricture after Endoscopic Drainage of Esophageal Abscess as a Complication of Acute Phlegmonous Esophagitis: A Case Report

Acute suppurative oesophagitis with fever and cough: A case report

New Endoscopic Solutions in Managing Phlegmonous Esophagitis

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