Abstract
Özofagus yaralanmaları acil müdahale gerektiren, tanı ve
tedavisindeki gecikmelerin mortalite ve morbiditede ciddi artışa yol açtığı
klinik bir tablodur. Endoskopik girişimlerin yaygınlaştığı günümüzde
iyatrojenik özofagus yaralanmaları artmıştır. Bu yazıda yabancı cisim (metal
para) aspire eden 3 yaşında bir hastada yaptığımız rijit özofagoskopi sırasında
meydana gelen özofagus perforasyonunun takip ve tedavisinde uyguladığımız
yaklaşımları paylaşıyoruz. Özofagoskopiden 2 gün sonra ateş, taşipne ve sağ
plevral efüzyon oluşması üzerine özofagus perforasyonu düşünüldü. Özofagus
perforasyonu servikal insizyon ile primer olarak onarıldı. 10 gün sonra çekilen
özofagogramda özofagustan ince bir kaçak şeklinde fistül görüldü. Hastanın
takibinde sağ hemitoraksta ampiyem ve şilotoraks gelişti. Antibiyoterapi,
betadinli plevral yıkama, somatostatin tedavisi, tüp torakostomi ile drenaj,
kimyasal plörodez, dekortikasyon ve duktus torasikus kütle ligasyonu uygulandı.
Postoperatif 88. gün hasta taburcu edildi.
References
- 1. Erdoğan A, Öz N, Sarper A, ve ark. Özofagus perforasyonları; 11 olgunun analizi. GKDC dergisi 1999; 7: 57-62.
- 2. Eisen GM, Baron TH, Dominitz JA, et al. Compliasions of upper GI endoskopy. Gastrointestinal Endoskopy 2002; 55:784-793.
- 3. Yenigün B; Çelik A, Kayı Cangır A. Özofagus yaralanmaları. TTD Toraks Cerrahisi Bülteni 2010; 1: 60-74 .
- 4. Asensio JA, Chahvan S, Forno W, et al. Penetrating esophageal injuries: multicenter study of the American Association for the Surgery of trauma. J Trauma- Injury. Infection Crit Care 2001; 50: 286-96.
- 5. Eroğlu A, Kurcuoglu IC, Karaoglanoglu N, et al. Esophageal Perforation: the emportance of early diagnosis and primary repair. Dis Esophagus 2004; 17: 91-94.
- 6. Eroglu A, Turkyilmaz A, Aydin Y, et al. Current manegement of esophageal perforation: 20 year experience. Dis Esophagus 2009; 22: 374-80.
- 7. Huber-Lang M, Henne Bruns D, Schmitz B, et al. Esophageal Perforation: principal of diagnosis and surgical management. Surg Today 2006; 36: 332-340.
- 8. Macler SA. Spontaneus Ruptureof the esophagus: An experimental and clinical study. Surg Gynecol Obstet 1952; 95: 345-356.
- 9. Pasricha PJ, Fleischer DE, Kalloo AN. Endoskopic perforations of the upper digestive tract: a review of their pathogenesis, prevention, and mangagement. Gastroenterolagy 1994; 106:787-802
Abstract
Esophageal injuries are a
clinical condition that requires urgent intervention and delays in diagnosis
and treatment lead to a significant increase in morbidity and mortality.
Iatrogenic esophageal injuries have increased as endoscopic procedures have
become widespread. In this paper, we present the approaches we applied in the
follow-up and treatment of esophageal perforation during rigid esophagoscopy in
a 3 year olds patient who aspirated foreign body (metal money). Two days after
esophagoscopy, fever, tachypnea, and right pleural effusion occurred,
esophageal perforation was considered. Esophageal perforation was primarily repaired cervical incision. After
10 days, the esophagogram revealed a fistula as a thin leak from the proximal
esophagus. Follow-up of the patient developed empyema and chylothorax in the
right thorax. Antibyotherapy, betadine pleural washing, somatostatin treatment,
tube drainage, chemical pleurodesis, decortication and ductus thoracicus mass
ligation were performed. The patient was discharged on the 88th postoperative
day.
References
- 1. Erdoğan A, Öz N, Sarper A, ve ark. Özofagus perforasyonları; 11 olgunun analizi. GKDC dergisi 1999; 7: 57-62.
- 2. Eisen GM, Baron TH, Dominitz JA, et al. Compliasions of upper GI endoskopy. Gastrointestinal Endoskopy 2002; 55:784-793.
- 3. Yenigün B; Çelik A, Kayı Cangır A. Özofagus yaralanmaları. TTD Toraks Cerrahisi Bülteni 2010; 1: 60-74 .
- 4. Asensio JA, Chahvan S, Forno W, et al. Penetrating esophageal injuries: multicenter study of the American Association for the Surgery of trauma. J Trauma- Injury. Infection Crit Care 2001; 50: 286-96.
- 5. Eroğlu A, Kurcuoglu IC, Karaoglanoglu N, et al. Esophageal Perforation: the emportance of early diagnosis and primary repair. Dis Esophagus 2004; 17: 91-94.
- 6. Eroglu A, Turkyilmaz A, Aydin Y, et al. Current manegement of esophageal perforation: 20 year experience. Dis Esophagus 2009; 22: 374-80.
- 7. Huber-Lang M, Henne Bruns D, Schmitz B, et al. Esophageal Perforation: principal of diagnosis and surgical management. Surg Today 2006; 36: 332-340.
- 8. Macler SA. Spontaneus Ruptureof the esophagus: An experimental and clinical study. Surg Gynecol Obstet 1952; 95: 345-356.
- 9. Pasricha PJ, Fleischer DE, Kalloo AN. Endoskopic perforations of the upper digestive tract: a review of their pathogenesis, prevention, and mangagement. Gastroenterolagy 1994; 106:787-802
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Case Report |
| Authors | |
| Publication Date | August 15, 2019 |
| Submission Date | April 3, 2019 |
| Acceptance Date | July 17, 2019 |
| Published in Issue | Year 2019 Volume: 5 Issue: 2 |
