Thoracic Aortic Pseudoaneurysm after Esophageal Perforation and Mediastinitis Caused by Accidental Ingestion of a Mutton Bone: A Case Report on Staged Endoscopic and Endovascular Treatments

Mezzetto, Luca; Treppiedi, Elio; Scorsone, Lorenzo; Giacopuzzi, Simone; Perandini, Simone; Macrì, Marco; Veraldi, Gian Franco

doi:10.1016/j.avsg.2015.07.025

Cited by 23 publications

(19 citation statements)

References 8 publications

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“…These complications may be a life-threatening [4][5][6][7][8]. The mediastinitis after cardiovascular surgery sometimes results in failure to complete all necessary procedures due to vein occlusion and strict adhesion and it may be result in more severe complications such as pseudoaneurysm [1,[9][10][11]. Therefore, for pediatric patients, accurate diagnosis of these complications and early intervention are important.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound evaluation of complications after cardiovascular surgery in pediatric patients: A case series

et al. 2020

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In contrast to computed tomography, ultrasound can be performed without radiation exposure, repeatedly performed by the patients’ bedside. Hence, in this case series, we describe the evaluation of complications including hematoma, superficialsurgical site infection, mediastinitis, and pseudoaneurysm associated mediastinitis using ultrasound in pediatric patients after cardiovascular surgery. To our knowledge, no previous reports have evaluated such complications using ultrasound. Ultrasound may be useful for the early diagnosis of these complications, and in the selection of subsequent examinations such as computed tomography, resulting in the early initiation of intervention.

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Section: Introductionmentioning

confidence: 99%

Ultrasound evaluation of complications after cardiovascular surgery in pediatric patients: A case series

et al. 2020

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“…[3] Sharp and pointed foreign bodies may penetrate the esophageal wall and lead to complications, such as neck abscess, spinal epidural abscess, esophageal perforation, mediastinitis, and artery and lung injury, which are life threatening. [4–6] Therefore, when objects, especially sharp, pointed and large objects, are diagnosed as esophageal foreign bodies, effective treatments should be administered as soon as possible to avoid serious complications and decrease recovery time. [7]…”

Section: Discussionmentioning

confidence: 99%

A fish bone induced aortic arch pseudoaneurysm in a male patient

Wang¹,

Zhou

Huang

2019

Medicine

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Rationale: Esophageal foreign body is a commonly seen in China. However, pseudoaneurysm of the aortic arch caused by ingestion of fish bones is a rare, life-threatening condition. Patient concerns: A 71-year-old male was admitted to the Ear, Nose, and Throat department with a 4-day history of chest pain after eating fish. Diagnoses: After taking out the fish bone by rigid endoscopy, magnetic resonance imaging and computerized tomography angiography (CTA) scans revealed the presence of an aortic arch pseudoaneurysm, which was likely caused by the fish bone. Interventions: A successful endovascular graft exclusion surgery was performed to block the aorta ulcer. Outcomes: The patient recovered and was discharged 20 days after hospitalization. The patient was healthy and had no fever or chest pain 4 months after discharge from the hospital. Lessons: Esophageal foreign bodies may lead to life-threatening impairment of the aorta or other big arteries. When esophageal foreign bodies puncture the esophageal wall, especially in the second stenosis of the esophagus, an enhanced-contrast computed tomography scan or a CTA scan may be necessary to exclude any potential impairment of the arteries.

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“…Extraluminal migration of an FB may damage nearby structures such as the trachea, aorta, or lung or lead to infection, manifesting as either a local abscess or necrotizing mediastinitis. 2,3 Contained perforations of the thoracic esophagus are generally managed by conservative measures, which include nothing by mouth, intravenous antibiotics and fluids, and analgesia. 4 In the present case, several features prompted operative management with VATS: (1) persistent symptoms due to the compressive effects of the abscess, (2) no evidence of esophageal perforation on EGD, and (3) the presence of a metallic FB adjacent to the superior vena cava.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 Contained perforations of the thoracic esophagus are generally managed by conservative measures, which include nothing by mouth, intravenous antibiotics and fluids, and analgesia. 4 In the present case, several features prompted operative management with VATS: (1) persistent symptoms due to the compressive effects of the abscess, (2) no evidence of esophageal perforation on EGD, and (3) the presence of a metallic FB adjacent to the superior vena cava. Thoracoscopic techniques are currently standard of care for a variety of thoracic and mediastinal pathologies, offer excellent operative exposure, and have been successfully utilized in similar complicated cases of FB ingestion.…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic management of a mediastinal abscess caused by extra-esophageal migration of a metal brush bristle

Ebrahim

Still

Schwartz

2018

Baylor University Medical Center Proceedings

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Foreign body perforations of the esophagus are infrequent events yet have the potential to cause significant morbidity and mortality. The clinical consequences of esophageal perforation by a foreign body are dependent upon the severity of infectious sequelae and damage to surrounding structures by the foreign object itself, as detailed in previous published reports. We describe the thoracoscopic management of a mediastinal abscess caused by a foreign body perforation in a patient with an intact esophagus.

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Thoracic Aortic Pseudoaneurysm after Esophageal Perforation and Mediastinitis Caused by Accidental Ingestion of a Mutton Bone: A Case Report on Staged Endoscopic and Endovascular Treatments

Cited by 23 publications

References 8 publications

Ultrasound evaluation of complications after cardiovascular surgery in pediatric patients: A case series

Ultrasound evaluation of complications after cardiovascular surgery in pediatric patients: A case series

A fish bone induced aortic arch pseudoaneurysm in a male patient

Thoracoscopic management of a mediastinal abscess caused by extra-esophageal migration of a metal brush bristle

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