An Innovative Technique to Repair Cervical Oesophageal Perforation using Oro-oesophageal Tube and AMBU

Article Sidebar

BJOHNS Aug 2019
pdf
Published: Aug 31, 2019
DOI: https://doi.org/10.47210/bjohns.2019.v27i2.247
Keywords:
Esophageal Perforation, Wounds, Gunshot

Main Article Content

Manish Gupta
Maharishi Markandeshwar Institute of Medical Science and Research, MMU, Ambala, Haryana, India.
Ginni Datta
Maharishi Markandeshwar Institute of Medical Science and Research, MMU, Ambala, Haryana, India.

Abstract

Introduction


Oesophageal perforation is a rare condition and has high morbidity and mortality. Both the morbidity and mortality are directly related to the delay in diagnosis and start of treatment. Primary closure with drainage is recommended if perforation is detected in less than 24 hours. Treatment for delayed or missed rupture of oesophagus is not very clear and is controversial.


Case Report


We hereby report a case of delayed diagnosed cervical oesophagus rupture following gunshot, which was primarily repaired. Special emphasis is on newer technique of fistula localization using oro-oesophageal tube and AMBU for better closure. The fistula closure was successful and no there were no post-operative complications.


Discussion


The symptoms and signs on presentation of patient of cervical oesophagus perforation are discussed along with the differing treatment paradigms for early versus late presentation. Surgical repair with primary closure may be undertaken, even in late presentation of oesophagus rupture. This technique of oro-oesophageal tube used along with AMBU, may be useful in cases of both cervical and upper thoracic oesophagus rupture. 

Article Details

How to Cite
1.
Gupta M, Datta G. An Innovative Technique to Repair Cervical Oesophageal Perforation using Oro-oesophageal Tube and AMBU. BJOHNS [Internet]. 2019Aug.31 [cited 2024Dec.4];27(2):171-5. Available from: https://bjohns.in/journal3/index.php/bjohns/article/view/247
Issue
Vol. 27 No. 2 (2019): Bengal Journal of Otolaryngology and Head Neck Surgery
Section
Case report
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Author Biographies

Manish Gupta, Maharishi Markandeshwar Institute of Medical Science and Research, MMU, Ambala, Haryana, India.

Professor & Head, Department of ENT

Ginni Datta, Maharishi Markandeshwar Institute of Medical Science and Research, MMU, Ambala, Haryana, India.

Associate Professor, Department of ENT

References

Bladergroen MR, Lowe JE, Postlethwait RW. Diagnosis and recommended management of esophageal perforation and rupture. Ann Thorac Surg. 1986; 42(3):235-9

Sarr M G, Pemberton J H, Payne W S. Management of instrumental perforations of the esophagus. J Thorac Cardiovasc Surg. 1982; 84(2):211-8

Okten I, Cangir AK, Ozdemir N, Kavukcu S, Akay H, Yavuzer S. Management of esophageal perforation. Surg Today 2001; 31(1):36-9

Bresadola V, Terrosu G, Favero A, Cattin F, Cherchi V, Adani GL, Marcellino MG, Bresadola F, De Anna D.. Treatment of perforation in the healthy esophagus: analysis of 12 cases. Langenbeck’s Arch Surg. 2008; 393(2):135-40

Kaman L, Iqbal J, Kundil B, Kochhar R. Management of esophageal perforation in adults. Gastroenterol Res. 2010; 3(6):235-44

Merchea A, Cullinane DC, Sawyer MD, Iqbal CW, Baron TH, Wigle D, Starr MG, Zielinski MD. Esophagogastroduodenoscopy-associated gastrointestinal perforations: a single center experience. Surgery 2010; 148:876-80, discussion 881-2

Enguidanos L, Pfleiderer A, Smith W, Ramkumar S. Pneumomediastinum secondary to an apparently trivial stab wound to the neck: the value of the Hamman’s sign and thorough radiological investigation. Emerg Med J. 2005; 22:230-1

Altorjay A, Kiss J, Voros A, Sziranyi E. The role of esophagectomy in the management of esophageal perforations. Ann Thorac Surg. 1998; 65(5):1433-6

Brennan J, Gibbons MD, Lopez M, Hayes D, Faulkner J, Eller RL, Barton C. Traumatic airway management in operation Iraqi freedom. Otolaryngol Head Neck Surg. 2011; 144:376-80

Mackler SA. Spontaneous rupture of the esophagus; an experimental and clinical study. Surg Gynecol Obstet. 1952; 95:345-56

Vial CM, Whyte RI. Boerhaave’s syndrome: diagnosis and treatment. Surg Clin North Am. 2005; 85:515-24

Arantes V, Campolina C, Valerio SH, de Sa RN, Toledo C, Ferrari TA, Coelho LG. Flexible esophagoscopy as a diagnostic tool for traumatic esophageal injuries. J Trauma 2009; 66:1677-82

Soong Wj. Endoscopic diagnosis and management of iatrogenic cervical esophageal perforation in extremely premature infants. J Chin Med Assoc. 2007; 70:171-5

Skinner DB, Little AG, DeMeester TR. Management of esophageal perforation. The Am J Surg. 1980; 139:760-4

Gouge TH, Depan HJ, Spencer FC. Experience with the Grillo pleural wrap procedure in 18 patients with perforation of the thoracic esophagus. Ann Surg. 1989; 209(5):612-7;discussion 617-9

Harries K, Masoud A, Brown TH, Richards DG. Endoscopic placement of fibrin sealant as a treatment for a long-standing Boerhaave’s fistula. Dis Esophagus 2004; 17(4):348-50

Wu JT, Mattox KL, Wall MJ, Jr. Esophageal perforations: new perspectives and treatment paradigms. J Trauma 2007; 63(5):1173-84

Ong GK, Freeman RK. Endoscopic management of esophageal leaks. J Thorac Dis. 2017; 9(Suppl 2):S135-S145