Late oesophageal perforation after intraoperative transoesophageal echocardiography.
Serious haemodynamic instability occurred during emergency surgery for a perforated duodenal ulcer in a 72-year-old man with acute myocardial infarction. Intraoperative transoesophageal echocardiography was crucial for diagnosis of the location of myocardial infarction in the right ventricle and the subsequent haemodynamic management. Postoperatively, a thrombus in the right coronary artery was removed by coronary angiography. The patient's trachea was extubated on the fourth postoperative day. Another 4 days later a leak in the lower oesophagus was suspected because of pleural empyema, and verified. The patient's trachea had to be re-intubated and an oesophageal stent was inserted. The patient was discharged, fully recovered, 2 months after the operation.
Zalunardo
M P
MP
Department of Anaesthesiology, University Hospital Zürich, Switzerland.
Bimmler
D
D
Grob
U C
UC
Stocker
R
R
Pasch
T
T
Spahn
D R
DR
D000368:Aged; D004381:Duodenal Ulcer / Q000150:complications / Q000601:surgery; D017548:Echocardiography, Transesophageal / Q000009:adverse effects*; D004939:Esophageal Perforation / Q000209:etiology*; D006801:Humans; D007430:Intraoperative Care / Q000009:adverse effects*; D007431:Intraoperative Complications / Q000000981:diagnostic imaging; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging; D010439:Peptic Ulcer Perforation / Q000601:surgery; D011183:Postoperative Complications