Esophageal Perforation: A Rare Complication of Transesophageal Echocardiography in a Patient with Asymptomatic Esophagitis

Abstract

Transesophageal echocardiography (TEE) is a commonly used procedure in patients with suspected endocarditis. A rare but dreadful complication of this procedure is perforation of the esophagus. We report the case of an elderly female with multiple comorbidities, who presented with polyarticular septic arthritis. TEE was performed to rule out endocarditis. Though the standard procedure protocol was followed, she developed esophageal perforation. It was managed with esophageal stenting but she developed multiorgan failure and did not survive. This case highlights the potential of severe morbidity and mortality associated with TEE. Appropriate screening must be done and high-risk individuals must be identified before such procedures are attempted.

Transthoracic Echocardiography in Prone Patients With Acute Respiratory Distress Syndrome: A Feasibility Study

“…TTE is less labor intensive, poses far fewer risks to the patient, and can be readily performed by critical care physicians at the bedside of prone ARDS patients. Furthermore, TEE presents a rare but potentially catastrophic risk of esophageal perforation ( 12 – 14 ). TEE probe insertion and manipulation can be cumbersome and technically challenging in the prone position, further increasing risk for mechanical complications ( 15 ).…”

Oesophageal perforation following transoesophageal echocardiography: A case report on successful conservative management

“…Recent evidence has shifted towards more conservative management of oesophageal perforations [13]. It compromises of keeping the patient nil-by-mouth, nasogastric suction, broad-spectrum antibiotics and parenteral nutrition.…”

“…It compromises of keeping the patient nil-by-mouth, nasogastric suction, broad-spectrum antibiotics and parenteral nutrition. The placement of oesophageal endoscopic stents in oesophageal perforation appears to be a promising non-operative approach [11,13]. Oesophageal injury from the TOE probe is ideal cases for endoscopic stent placement as there is minimal bacterial contamination [11].…”

Gastrointestinal Dysfunction in Multiple Sclerosis and Related Conditions

“…Gastroparesis, indicated by prolonged gastric emptying, has been described most frequently, but as noted above, accelerated gastric emptying was even more frequently evident in one study. 58 59 60 61 62 Abdominal X-rays can visualize IPO/paralytic ileus. 38 Delayed CTT can also be identified by bowel function testing 63 64 65 even when rectal videomanometry confirms intact rectal sensory parameters.…”