Endotherapy for a 5-cm mid-esophageal perforation with tandem stenting above the lower esophageal sphincter (with videos)

Shou Jiang Tang, Shailender Singh, Michael A. Wait, Mary A. Mullican, Daniel J. Scott

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Esophageal perforation, whether spontaneous or more commonly as a result of instrumentation, is a life-threatening condition and carries high mortality despite recent advances. Outcome is dependent on etiology, location of injury, and interval between perforation and initiation of therapy. Successful management of esophageal perforation entails combination of: (1) control of the leakage site either surgically or endoscopically to prevent further contamination, (2) drainage of contamination, and (3) appropriate antibiotics along with nutritional support. Methods: We report one case with a 5-cm-long iatrogenic mid-esophageal perforation. The perforation was successfully managed with esophageal tandem stenting above the lower esophageal sphincter (LES). Results: The radial expansile force of the inner stent and its anchorage by LES holds the outer stent in place and prevents the tandem stents migrating distally. Conclusions: Successful management of esophageal perforation depends on early diagnosis, control of site of leak, drainage of accompanying collections, and antibiotic and nutritional support.

Original languageEnglish (US)
Pages (from-to)2836-2841
Number of pages6
JournalSurgical endoscopy
Volume23
Issue number12
DOIs
StatePublished - Dec 2009

Fingerprint

Esophageal Perforation
Lower Esophageal Sphincter
Stents
Nutritional Support
Drainage
Anti-Bacterial Agents
Early Diagnosis
Mortality
Wounds and Injuries

Keywords

  • Bariatrics
  • Endoscopy
  • Esophageal tandem stenting
  • Esophagus
  • Gastric banding
  • Lower esophageal sphincter
  • Obesity
  • Perforation
  • Stenting
  • Surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Endotherapy for a 5-cm mid-esophageal perforation with tandem stenting above the lower esophageal sphincter (with videos). / Tang, Shou Jiang; Singh, Shailender; Wait, Michael A.; Mullican, Mary A.; Scott, Daniel J.

In: Surgical endoscopy, Vol. 23, No. 12, 12.2009, p. 2836-2841.

Research output: Contribution to journalArticle

Tang, Shou Jiang ; Singh, Shailender ; Wait, Michael A. ; Mullican, Mary A. ; Scott, Daniel J. / Endotherapy for a 5-cm mid-esophageal perforation with tandem stenting above the lower esophageal sphincter (with videos). In: Surgical endoscopy. 2009 ; Vol. 23, No. 12. pp. 2836-2841.
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