Esophageal Perforation, the Most Feared Complication of TEE: Early Recognition by Multimodality Imaging

Bavalia, Nisha; Anis, Ather; Benz, Michael; Maldjian, Pierre D.; Bolanowski, Paul J.P.; Sarić, Muhamed

doi:10.1111/j.1540-8175.2010.01291.x

Cited by 50 publications

(30 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other authors have suggested up-front multi-modal imaging to guide diagnosis and treatment [19]. In the current study, the single most predictive imaging finding was the presence of a retropharyngeal fluid collection.…”

Section: Commentmentioning

confidence: 74%

Management of cervical esophageal and hypopharyngeal perforations

Zenga¹,

Kreisel²,

Kushnir³

et al. 2015

American Journal of Otolaryngology

View full text Add to dashboard Cite

Section: Commentmentioning

confidence: 74%

Management of cervical esophageal and hypopharyngeal perforations

Zenga¹,

Kreisel²,

Kushnir³

et al. 2015

American Journal of Otolaryngology

View full text Add to dashboard Cite

“…All lesions resulting from dilatation, mucosectomy and rigid endoscopy healed sustainably after stenting. Lesions after TEE are typically located in the cervical esophagus [15] and are best treated by over-sewing and drainage [16]. 5 lesions (two distal, two in the thoracic part, and only one in the cervical esophagus) of this type in our sample were treated in 60% (3/5) successfully by one single stent.…”

Section: Discussionmentioning

confidence: 85%

Self-expandable stents for benign esophageal leakages and perforations: long-term single-center experience

Gubler

Bauerfeind

2013

Scandinavian Journal of Gastroenterology

View full text Add to dashboard Cite

OBJECTIVE: To date, there is no standardized treatment for esophageal perforations and leakages caused by underlying benign diseases, and it is still debated whether a conservative, endoscopic treatment or a surgical approach is preferable. However, some cases series have successfully demonstrated the feasibility of a temporary placement of self-expanding stents. DESIGN: All patients with benign leakages of the esophagus or gastroesophageal junction or fistulas at gastroesophageal anastomosis were collected during the past 12 years and analyzed retrospectively. The patients treated with endoscopic stenting were analyzed for sustained success, complications, time to stenting, lesion size, number of stents used, need for percutaneous drainage. RESULTS: Eighty-five of eight-eight patients were included in this analysis. Three patients were conservatively managed only. The success rate of stent treatment with an average of 1.3 stents was 79%. Success was highest (94%, n = 30 of 32, no complications or mortality) in iatrogenic lesions that were immediately diagnosed and treated. Spontaneous lesions, including lesions due to Boerhaave's syndrome, were healed in 73% and anastomotic leakages were closed in 71%. Fistula had a lower success rate of 43%. Use of multiple stents sequentially placed was necessary in 23% of the cases. Percutaneous drainage was necessary in 25% of all cases. CONCLUSION: Temporary stent placement for benign leakages of the esophagus is safe and seems to improve treatment success. Adjacent fluid collections should be drained percutaneously. Contributors: CG and PB collected and interpreted patient's data. They drafted the manuscript together and approved its final version. Funding: There was no funding for this 12 years ongoing studyCompeting interests: CG and PB have no competing interests to declare. 3 AbstractObjective: To date, there is no standardized treatment for esophageal perforations and leakages caused by underlying benign diseases, and it is still debated whether a conservative, endoscopic treatment or a surgical approach is preferable. However, some cases series have successfully demonstrated the feasibility of a temporary placement of self-expanding stents.Design: All patients with benign leakages of the esophagus or gastroesophageal junction or fistulas at gastroesophageal anastomosis were collected during the last 12 years and analysed retrospectively. The patients treated with endoscopic stenting were analysed for sustained success, complications, time to stenting, lesion size, number of stents used, need for percutaneous drainage.Results: 85 of 88 patients were included in this analysis. Three patients were conservatively managed only. The success rate of stent treatment with an average of 1.3 stents was 79%.Success was highest (94%, n=30 of 32, no complications or mortality) in iatrogenic lesions that were immediately diagnosed and treated. Spontaneous lesions, including lesions due to Boerhaave's syndrome, were healed in 73% and anastomotic leakages were closed in 71...

show abstract

“…The most commonly reported complications of TEE (such as lip injury and hoarseness) do not usually require significant medical intervention . Thankfully, life‐threatening complications are rare, with the incidence of esophageal perforation reported to be 0.01–0.09% . The mechanism of esophageal injury during a TEE examination is thought to be a combination of thermal energy from the probe tip and direct trauma and pressure during probe insertion, manipulation, and removal …”

Section: Discussionmentioning

confidence: 99%

Extrinsic Esophageal Compression by Cervical Osteophytes in Diffuse Idiopathic Skeletal Hyperostosis: A Contraindication to Transesophageal Echocardiography?

et al. 2015

Self Cite

View full text Add to dashboard Cite

Contraindications to transesophageal echocardiography (TEE) include various esophageal pathologies, but compression of the esophagus by vertebral osteophytes is not listed in the current American Society of Echocardiography guidelines. We report a case of diffuse idiopathic skeletal hyperostosis (DISH) in an 81-year-old man who had incidentally been found to have extrinsic esophageal compression by cervical osteophytes prior to a proposed TEE. The incidence of esophageal perforation in patients with DISH and vertebral osteophytes is not well documented. We believe these patients are at increased risk of esophageal perforation during TEE, and thus, TEE may be relatively contraindicated in patients with DISH.

show abstract

Esophageal Perforation, the Most Feared Complication of TEE: Early Recognition by Multimodality Imaging

Cited by 50 publications

References 6 publications

Management of cervical esophageal and hypopharyngeal perforations

Management of cervical esophageal and hypopharyngeal perforations

Self-expandable stents for benign esophageal leakages and perforations: long-term single-center experience

Extrinsic Esophageal Compression by Cervical Osteophytes in Diffuse Idiopathic Skeletal Hyperostosis: A Contraindication to Transesophageal Echocardiography?

Contact Info

Product

Resources

About