First Successful Treatment of a Circumferential Intramural Esophageal Dissection with Perforation in a Patient with Eosinophilic Esophagitis Using a Partially Covered Self-Expandable Metal Stent

FischerAndreas,; HöppnerJens,; Richter-SchragHans-Jürgen,

doi:10.1089/lap.2014.0594

Cited by 7 publications

(3 citation statements)

References 8 publications

(18 reference statements)

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“…In the existing literature, spontaneous esophageal perforation has been described in 22 cases published over 16 articles (Table 4), and 13 cases were associated with food impaction. 7, 8, 23–35 When the 10 cases presented here are added to those previously reported in the literature, 7, 8, 23–35 21 out of a total of 32 reported perforations in EoE have been associated with food bolus impaction. This association may be explained by several factors.…”

Section: Discussionmentioning

confidence: 84%

“…In the EoE literature, there are 12 cases with documented full-thickness perforations identified by contrast leak or frank pneumomediastinum out of a total of 22 reported perforations. 7, 8, 23–35 In addition, EoE patients who suffer perforation do so at a relatively young age (mean 32.5 yrs in this cohort), and this likely improves their morbidity after surgery.…”

Section: Discussionmentioning

confidence: 86%

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Causes and Outcomes of Esophageal Perforation in Eosinophilic Esophagitis

Runge¹,

Eluri²,

Cotton³

et al. 2017

Journal of Clinical Gastroenterology

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Goals To characterize patients who suffer perforation in the context of EoE and to identify predictors of perforation Background Esophageal perforation is a serious complication of eosinophilic esophagitis (EoE). Methods We conducted a retrospective cohort study of the UNC EoE clinicopathologic database from 2001–2014. Subjects were included if they had an incident diagnosis of EoE and met consensus guidelines, including non-response to a PPI trial. Patients with EoE who had suffered perforation at any point during their course were identified, and compared to EoE cases without perforation. Multiple logistic regression was performed to determine predictors of perforation. Results Out of 511 subjects with EoE, 10 (2.0%) had experienced an esophageal perforation. While those who perforated tended to have a longer duration of symptoms prior to diagnosis (11.4 vs. 7.0 years, p=0.13), a history of food impaction (OR 14.9; 95% CI 1.7–129.2) and the presence of a focal stricture (OR 4.6; 1.1–19.7) were the only factors independently associated with perforation. Most perforations (80%) occurred after a prolonged food bolus impaction, and only half of individuals (5/10) carried a diagnosis of EoE at the time of perforation; none occurred after dilation. Six patients (60%) were treated with non-operative management, and four (40%) required surgical repair. Conclusion Esophageal perforation is a rare but serious complication of eosinophilic esophagitis, occurring in approximately 2% of cases. Most episodes are due to food bolus impaction or strictures, suggesting that patients with fibrostenotic disease due to longer duration of symptoms are at increased risk.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 86%

Causes and Outcomes of Esophageal Perforation in Eosinophilic Esophagitis

Runge¹,

Eluri²,

Cotton³

et al. 2017

Journal of Clinical Gastroenterology

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“…This endoscopic procedure has been proven to be simple and effective in several cases[ 11 - 13 ]. In rare cases, IED has been treated with self-expandable metal stents and endoscopic dilation[ 14 , 15 ]. Given its safety and effectiveness, we highly recommend endoscopic incision as a routine therapeutic modality for IED.…”

Section: Discussionmentioning

confidence: 99%

Submucosal esophageal abscess evolving into intramural submucosal dissection: A case report

Yang¹,

Sikong²,

Zhang³

et al. 2022

World J Clin Cases

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BACKGROUND Here we report a rare case of submucosal esophageal abscess evolving into intramural submucosal dissection. CASE SUMMARY An 80-year-old woman was admitted to our emergency department with a chief complaint of dysphagia and fever. Laboratory tests showed mild leukocytosis and elevated C-reactive protein level. Computed tomography showed thickening of the esophageal wall. Upper endoscopy showed a laceration of the esophageal mucosa and a submucosal mass. Spontaneous drainage occurred, and we could see purulent exudate from the crevasse. We closed the laceration with endoscopic clips. The patient did not remember swallowing a foreign body; however, she ate crabs before the symptoms occurred. We prescribed the patient with antibiotic, and the symptoms were gradually relieved. Two months later, upper endoscopy showed that the laceration was healed, and the submucosal abscess disappeared. However, intramural esophageal dissection was formed. We performed endoscopic incision of the septum using dual-knife effectively. CONCLUSION In conclusion, we are the first to report the case of esophageal submucosal abscess evolving into intramural esophageal dissection. The significance of this case lies in clear presentation of the evolution process between two disorders. In addition, we recommend that endoscopic incision be considered as one of the routine therapeutic modalities of intramural esophageal dissection.

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Circumferential intramural esophageal dissection with large mucosal defect

Anand

2020

Clin J Gastroenterol

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First Successful Treatment of a Circumferential Intramural Esophageal Dissection with Perforation in a Patient with Eosinophilic Esophagitis Using a Partially Covered Self-Expandable Metal Stent

Cited by 7 publications

References 8 publications

Causes and Outcomes of Esophageal Perforation in Eosinophilic Esophagitis

Causes and Outcomes of Esophageal Perforation in Eosinophilic Esophagitis

Submucosal esophageal abscess evolving into intramural submucosal dissection: A case report

Circumferential intramural esophageal dissection with large mucosal defect

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