Endoscopic Transesophageal Drainage of Mediastinal Abscesses Caused by Anastomotic Leakage

Abstract

Mediastinal abscesses caused by anastomotic leakage following esophago‐gastrostomy are associated with high morbidity and mortality. Surgical treatments are often difficult because of the presence of inflammation and adhesions. Percutaneous drainage techniques are limited due to the location of the esophagus. We attempted endoscopic transesophageal drainage in a 74‐year‐old male with a mediastinal abscess due to anastomotic leakage. This method reduced discharge into the cavity, and excellent drainage was obtained. It was less traumatic than techniques that employ flexible bronchofiberscopy. We were able to insert a guidewire through the anastomotic disruption site into the abscess cavity for observation. Endoscopic transesophageal drainage is therefore a safe and reliable technique for mediastinal abscesses caused by anastomotic leakage of esophago‐gastrostomy. (Dig Endosc 1996; 8: 236‐238)