[Undetected hypopharyngeal perforation with deep neck abscess and mediastinitis due to transesophageal echocardiography].
Hypopharyngeal perforation is a rare but dangerous complication caused by diagnostic procedures. If there is any suspicion of perforation of the upper airways and/or upper digestive tract, immediate diagnostic and therapeutic procedures are indicated. Possible complications of a hypopharyngeal perforation are deep neck infection with subsequent mediastinitis and haemorrhage from major cervical vessels, both of which have high mortality rates. We present the case of a 65 year old male patient with perforation of the hypopharynx after transesophageal echocardiography which was unrecognized for more than 1 week. Clinical symptoms of hypopharyngeal perforation may initially be unspecific. Esophagography (Gastrografin administration) and computed tomography as well as esophagoscopy are needed to certify the diagnosis and to evaluate the extent of the lesion. Pathological findings as well as diagnostic and therapeutic needs are demonstrated and discussed.
Eichhorn
K W G
KW
Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde und Poliklinik, Universitätsklinikum Freiburg.
Bley
T A
TA
Ridder
G J
GJ
D000368:Aged; D000900:Anti-Bacterial Agents; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging*; D002177:Candidiasis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D017548:Echocardiography, Transesophageal / Q000009:adverse effects*; D004724:Endoscopy; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging; D006333:Heart Failure / Q000000981:diagnostic imaging*; D006801:Humans; D007013:Hypopharynx / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008297:Male; D008480:Mediastinitis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D017703:Retropharyngeal Abscess / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D013290:Streptococcal Infections / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D034361:Streptococcus mitis; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents