Thoracic Complications of Esophageal Disorders

Giménez, A.; Franquet, Tomás; Erasmus, Jeremy J.; Martínez, Santiago; Estrada, Pilar

doi:10.1148/radiographics.22.suppl_1.g02oc18s247

Cited by 134 publications

(81 citation statements)

References 33 publications

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“…These findings are comparable to radiologic findings by Chaky et al (2008) in their report on chest-CT diagnosis of adult bronchoesophageal fistula [10] and Erasmus et al (2002) report on esophageal perforation [11]. Chaky et al (2008) also report that the fistula orifice can be demonstrated by a virtual endoluminal view using CT data [10].…”

Section: Discussionsupporting

confidence: 73%

Esophagobronchial Fistula Complicating Isolated Esophageal Crohn’s: A Case Report

Asarian

2014

J Med Cases

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Isolated esophageal Crohn's is a rare condition with few reported cases; there are even much fewer documented case reports of esophagobronchial fistula complicating esophageal Crohn's. We present a case of isolated esophageal Crohn's with esophagobronchial fistula presenting with hemoptysis. Diagnostic considerations and therapeutic options are detailed. We recommend chest computerized tomography (with computerized virtualization of endoluminal data when available) as the imaging modality of choice, as well as traditional studies: barium swallow, bronchoscopy and upper gastrointestinal endoscopy, for a complete elucidation of all associated clinical entities. We conclude by making the case for entertaining a diagnosis of esophagobronchial or related fistulas in patients with Crohn's disease who present with interval development of respiratory symptoms or signs especially when these are persistent or recurrent.

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Section: Discussionsupporting

confidence: 73%

Esophagobronchial Fistula Complicating Isolated Esophageal Crohn’s: A Case Report

Asarian

2014

J Med Cases

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“…Early diagnosis of esophageal perforation allows prompt institution and appropriate medical and surgical intervention [23,24]. In our series, mediastinitis developed in 57% of the patients who were referred to the CT department.…”

Section: Discussionmentioning

confidence: 73%

Acute mediastinitis: spectrum of computed tomography findings

Exarhos

Malagari²,

Tsatalou

et al. 2004

Eur Radiol

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The objective of this study was to describe CT findings and to determine the diagnostic value of CT in diagnosis of acute mediastinitis. CT findings were retrospectively studied in 40 patients with suspected acute mediastinitis, including 28 postoperative patients, five with acute descending necrotizing mediastinitis (ADNM), and seven with suspected post-traumatic perforation of the esophagus. Findings included increased attenuation of mediastinal fat (100%), localized mediastinal fluid collections (55%), free gas bubbles in the mediastinum (57.5%), mediastinal lymph nodes (35%), pericardial effusions (27.5%), pleural effusions (85%), lung infiltrates (35%), sternal dehiscence (40%), and pleuromediastinal fistula (2.5%). The sensitivity and specificity of CT in postoperative patients in the first 17 days was 100% and 33% respectively, and after day 17, 100% and 90%. In patients with ADNM sensitivity was 100% while in patients with suspected esophageal perforation sensitivity and specificity were 100%. CT is a highly sensitive technique for the detection of mediastinitis of various causes. For the postoperative patients there is clear time dependence for CT interpretation and accuracy. In patients with suspected ADNM, and traumatic esophageal perforation CT is highly specific early after clinical presentation.

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“…Some authors consider it to be the gold standard examination to establish the diagnosis of esophageal lesions 18,19 .…”

Section: Discussionmentioning

confidence: 99%

Efficacy of surgical versus conservative treatment in esophageal perforation: a systematic review of case series studies

et al. 2013

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PURPOSE:To evaluate the efficacy of surgical treatment for esophageal perforation. METHODS:A systematic review of the literature was performed. We conducted a search strategy in the main electronic databases such as PubMed, Embase and Lilacs to identify all case series. RESULTS:Thirty three case series met the inclusion criteria with a total of 1417 participants. The predominant etiology was iatrogenic (54.2%) followed by spontaneous cause (20.4%) and in 66.1% the localization was thoracic. In 65.4% and 33.4% surgical and conservative therapy, respectively, was considered the first choice. There was a statistically significance different with regards mortality rate favoring the surgical group (16.3%) versus conservative treatment (21.2%) (p<0.05). CONCLUSION:Surgical treatment was more effective and safe than conservative treatment concerning mortality rates, although the possibility of bias due to clinical and methodological heterogeneity among the included studies and the level of evidence that cannot be ruled out.

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Thoracic Complications of Esophageal Disorders

Cited by 134 publications

References 33 publications

Esophagobronchial Fistula Complicating Isolated Esophageal Crohn’s: A Case Report

Esophagobronchial Fistula Complicating Isolated Esophageal Crohn’s: A Case Report

Acute mediastinitis: spectrum of computed tomography findings

Efficacy of surgical versus conservative treatment in esophageal perforation: a systematic review of case series studies

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