Unusual cause of esophageal perforation during intraoperative transesophageal echocardiography monitoring for cardiac surgery--a case report.
Although esophageal perforation after transesophageal echocardiographic (TEE) examination is rare yet the occurrence of this life-threatening complication is increasing. We report an unusual esophageal perforation occurring 4 days after coronary artery bypass graft surgery and Bentall's procedure. The perforation was due to inadvertent injury of the esophagus that was deformed and distorted by a large calcified lymph node in the mediastinum during intraoperative TEE instrumentation. We suggest that careful preoperative radiological examination of the mediastinum should be done to recognize the anatomical pathology in patient whose routine chest X-ray has disclosed a large calcified lymph node in the mediastinum, if he happens to undergo TEE, so as to avoid disastrous esophageal perforation.
Pong
Ming-Wen
MW
Department of Anesthesiology, National Yang-Ming University, Taipei-Veterans General Hospital, Taipei, Taiwan, R.O.C.
Lin
Su-Man
SM
Kao
Sheng-Chin
SC
Chu
Chi-Chun
CC
Ting
Chien-Kun
CK
Tsai
Shen-Kou
SK
D001026:Coronary Artery Bypass; D017548:Echocardiography, Transesophageal / Q000009:adverse effects*; D004939:Esophageal Perforation / Q000209:etiology*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D008875:Middle Aged; D016343:Monitoring, Intraoperative