Esophageal perforation: CT findings.

White, Charles S.; Templeton, Philip A.; Attar, Safuh

doi:10.2214/ajr.160.4.8456662

Cited by 144 publications

(64 citation statements)

References 15 publications

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“…The site of perforation was visible in a high proportion of patients in the present study who underwent CT or MDCT. White et al (19) found that CT was useful for diagnosing patients without typical symptoms and have suggested useful findings for esophageal rupture to be the presence of esophageal thickening, periesophageal fluid, and extraluminal air. These findings were also found in 16.7% to 100% of our patients with empyema due to esophagopleural fistula.…”

Section: Empyema Due To Esophagopleural Fistulamentioning

confidence: 99%

Isolation of Candida Species is an Important Clue for Suspecting Gastrointestinal Tract Perforation as a Cause of Empyema

Ishiguro¹,

Takayanagi²,

Ikeya

et al. 2010

Intern. Med.

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Background Empyema due to Candida species is a rare entity, and the significance of isolation of Candida species from the pleural effusion is not fully understood. Objective To elucidate the clinical features of Candida empyema. Methods We retrospectively reviewed the cases of 128 patients with culture-positive empyema. Results These 128 patients included 7 whose cause of empyema was esophago-or gastropleural fistula. Empyema was due to Candida species in 5 of the 7 patients. Primary diseases of these 5 patients were spontaneous esophageal rupture in 3 patients, esophageal rupture due to lung cancer invasion in 1 patient, and gastric ulcer perforation in 1 patient. None of these 5 patients had esophageal candidiasis. Among the 121 other patients with empyema not due to esophago-or gastropleural fistula, no patient had empyema due to Candida. Conclusion We believe that the empyema in these 5 patients was caused by normal commensal Candida species entering the pleural cavity when the fistula between the gastrointestinal tract and pleural cavity was formed. Isolation of Candida species can be an important clue for suspecting gastrointestinal tract perforation as a cause of empyema.

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Section: Empyema Due To Esophagopleural Fistulamentioning

confidence: 99%

Isolation of Candida Species is an Important Clue for Suspecting Gastrointestinal Tract Perforation as a Cause of Empyema

Ishiguro¹,

Takayanagi²,

Ikeya

et al. 2010

Intern. Med.

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“…White et al [21] report that extraluminal air was the most useful CT finding which was present in 92% of their patients. Exarhos et al [8] investigated sensitivity and specificity of CT imaging in acute mediastinitis.…”

Section: Discussionmentioning

confidence: 91%

Extension injury of the thoracic spine with rupture of the oesophagus and successful conservative therapy of concomitant mediastinitis

et al. 2009

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The case of an upper oesophageal perforation as a concomitant injury of an isolated fracture of the upper thoracic spine without neurological compromise has not been described so far. A Case report and review of the literature is presented here. Concomitant oesophageal perforations carry a high risk of being missed initially. CT alone can visualize the subtle indirect signs like peri-oesophageal air. The literature revealed that only peri-oesophageal air might be a valid indicator of oesophageal injury. There are no systematic data on thoracic spine fractures with concomitant oesophageal perforations. Mediastinitis secondary to oesophageal perforation might be treated conservatively with endoscopic stent placement rather than surgically. As the radiological signs of concomitant soft tissue injury, like oesophageal perforations, in fractures of the upper thoracic spine are subtle and easily missed initially only anticipation of concomitant injuries by the treating physician based on the trauma mechanism ensures a timely diagnosis.

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“…27 El elemento mas útil para el diagnostico tomográfico de perforación es la presencia de aire extra-luminal. 28 La utilización de la TC tiene una sensibilidad de 100% y es la primera opción para el diagnóstico de cuerpo extraño a nivel del esófago superior si se sospecha que el mismo no será visible en la radiografía. 29 La alta resolución y sensibilidad de la TC hacen de éste un estudio de alto rendimiento diagnóstico para detectar cuerpos extraños.…”

Section: Discussionunclassified

Ingesta de Cuerpos Extraños Estudio Prospectivo Observacional. Conducta Terapéutica y Resultados

Trostchansky¹,

Masaferro²

2017

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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OEl 80-90% de los cuerpos extraños ingeridos voluntaria o accidentalmente se evacuan espontáneamente, sin embargo se requiere de una endoscopia terapéutica en un 10-20% de los casos y de cirugía en menos del 1% de los mismos.Objetivo: Analizar las características de los pacientes asistidos por ingesta de cuerpo extraño en el Departamento de Emergencia del Hospital Maciel y llegar al diseño de guías de actuación en el contexto de un equipo multidisciplinario.Resultados: Nuestra serie constó de 31 consultas por ingesta de cuerpo extraño. El 52% provenía de instituciones psiquiátricas y el 42% eran reclusos, un caso no pertenecía a ninguna de las 2 categorías. El 27,5% de las consulta se habían producido en las primeras 24hs desde la ingesta, el 24% de las ingestas se habían producido con más de una semana desde la ingesta y el resto oscilaba entra ambos tiempos evolutivos En cuanto a la conducta, en 12 casos se otorgó el alta sin mediar conducta activa endoscópica y/o quirúrgica. Se realizó una FGC en el 64% de los casos en los cuales se constató radiológicamente la ingesta de un cuerpo extraño, siendo efectivamente terapéuticas para la extracción de objetos a nivel gastroduodenal en el 67% de las mismas. De las 28 consultas por ingesta de CE 6 pacientes (21%) fueron operados. En 5 de ellos por falla de la extracción endoscópica, el restante se presentó como una peritonitis aguda. La ingesta de CE representa una patología de consulta frecuente en el Departamento de Emergencia. El manejo del mismo se realiza mediante un abordaje multidisciplinario que en el caso de nuestra serie mostró porcentajes de extracción endoscópica efectiva cercana al 70% comparable con otras series internacionales. El análisis de las características de la población analizada y el análisis de la evidencia científica publicada nos permite plantear un protocolo de actuación. Palavras Source of support: Nil Conflict of interest: None ABSTRACTAbout 80 to 90% of foreign bodies ingested voluntarily or accidentally are spontaneously ejected; however, a therapeutic endoscopy is required in 10 to 20% of cases and surgery in less than 1% of them.Objective: To analyze the characteristics of assisted patients due to foreign body ingestion in the Department of Emergency of Maciel Hospital and the design of protocols of action in the context of a multidisciplinary team. Results:Our series had 31 patients who came for consultation because of foreign body ingestion; 52% came from psychiatric care institutions, 42% were prisoners of state prison, and one case did not belong to any of the previous categories. About 27.5% of consultations occurred within the first 24 hours after ingestion, 24% of consultations in the Department of Emergency occurred after more than 1 week from ingestion, and the rest oscillated between both evolutionary times. Regarding the therapeutic behavior performed, in 12 cases it was decided to discharge the patient without active endoscopic conduct or surgery. A FGC was performed in 64% of cases in which the intake of the for...

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Esophageal perforation: CT findings.

Cited by 144 publications

References 15 publications

Isolation of Candida Species is an Important Clue for Suspecting Gastrointestinal Tract Perforation as a Cause of Empyema

Isolation of Candida Species is an Important Clue for Suspecting Gastrointestinal Tract Perforation as a Cause of Empyema

Extension injury of the thoracic spine with rupture of the oesophagus and successful conservative therapy of concomitant mediastinitis

Ingesta de Cuerpos Extraños Estudio Prospectivo Observacional. Conducta Terapéutica y Resultados

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