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Delayed perforation after endoscopic submucosal dissection treated successfully by temporary stent placement.
- Source :
-
Clinical journal of gastroenterology [Clin J Gastroenterol] 2018 Apr; Vol. 11 (2), pp. 118-122. Date of Electronic Publication: 2017 Dec 08. - Publication Year :
- 2018
-
Abstract
- A 71-year-old male patient with a long-segment (C10M12) Barrett's esophagus harboring multifocal high-grade dysplasia was referred to our clinic. After a multidisciplinary team conference and the patient's informed consent, an endoscopic submucosal dissection (ESD) was performed with resection of 4/5 of the esophageal circumference along 12 cm, without any complications during or immediately after the procedure. In the day after the ESD, the patient presented suddenly with dyspnea and subcutaneous emphysema in the neck and chest. A computed tomography (CT) showed subcutaneous emphysema in the neck and pneumomediastinum, confirming the diagnosis of delayed perforation. There was gradual progression into respiratory failure with the need for ventilatory support. Endoscopic treatment was decided and 2 fully covered self-expandable metal stents were deployed in the esophagus. Patient's clinical condition improved and oral diet was resumed at day 7. Stents were retrieved at day 12 and there were no strictures on the 2 and 6-month follow-ups. This is the first report of delayed perforation after endoscopic submucosal disection in the esophagus that was successfully managed with endoscopic therapy.
- Subjects :
- Aged
Duodenoscopy methods
Esophageal Perforation diagnostic imaging
Esophageal Perforation etiology
Esophagoscopy methods
Gastroscopy methods
Humans
Male
Postoperative Complications diagnostic imaging
Postoperative Complications etiology
Time Factors
Tomography, X-Ray Computed
Barrett Esophagus surgery
Endoscopic Mucosal Resection adverse effects
Esophageal Perforation surgery
Postoperative Complications surgery
Self Expandable Metallic Stents
Subjects
Details
- Language :
- English
- ISSN :
- 1865-7265
- Volume :
- 11
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Clinical journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 29222735
- Full Text :
- https://doi.org/10.1007/s12328-017-0808-2