Successful primary reinforced repair of esophageal perforation using a pedicled omental graft through a transhiatal approach.
Esophageal perforation is potentially lethal if untreated. We report a case of distal esophageal perforation probably caused by swallowing a fish bone. The patient initially received conservative treatment 4 days after the esophageal injury. The treatment was promptly changed from conservative to operative treatment owing to rapid manifestation of suppurative mediastinitis followed by peritonitis. The patient successfully underwent primary repair of the perforation buttressed with a pedicled omental graft pulled up through the esophageal hiatus following a laparotomy. We discuss the validity of this method of transhiatal approach without thoracotomy for primary repair of distal esophageal perforation.
Nishimaki
T
T
Department of Surgery, Faculty of Medicine, Niigata University, Niigata City, Japan. nishimak@med.niigata-u.ac.jp
Ono
K
K
Tada
T
T
Hatakeyama
K
K
D000368:Aged; D000818:Animals; D001842:Bone and Bones; D004939:Esophageal Perforation / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005547:Foreign Bodies / Q000150:complications*; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D009852:Omentum / Q000637:transplantation*; D011182:Postoperative Care; D011859:Radiography; D013908:Thoracotomy / Q000379:methods