Successful treatment of mediastinal gas gangrene due to esophageal perforation.
Esophageal perforation and mediastinal gas gangrene developed in a 55-year-old male after the endoscopic ethanol injection of a Mallory-Weiss ulcer. Initially, extensive gangrene of the esophagus and the mediastinum was treated by esophagectomy; however, an abundance of Clostridium perfringens in the Gram stain verified the presence of gas gangrene. Subsequently, the patient was transferred to a hyperbaric oxygen center, wherein a total of seven hyperbaric treatments were administered. The patient survived, and 4 months later, after having undergone several reoperations because of pleural empyema, mediastinal abscess, splenic rupture, and acalculous cholecystitis, was discharged and is still surviving.
Salo
J A
JA
Department of Thoracic and Cardiovascular Surgery, Helsinki University Central Hospital, Finland. jarmo.salo@huch.fi
Savola
J K
JK
Toikkanen
V J
VJ
Perhoniemi
V J
VJ
Pettilä
V Y
VY
Klossner
J A
JA
Toivonen
H J
HJ
D004939:Esophageal Perforation / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005500:Follow-Up Studies; D005738:Gas Gangrene / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008480:Mediastinitis / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D012086:Reoperation; D014057:Tomography, X-Ray Computed