title: [Drainage-lavage and closure of a late esophageal perforation with esophagopleural fistula and encysted pleural effusion after endoscopic injection sclerotherapy for varices].
abstract: We report a case of late perforation of the thoracic esophagus with an esophagopleural fistula after endoscopic sclerotherapy for esophageal varices in a Child-Pugh B9 cirrhotic patient. The existence of a thoracic empyema without diffuse mediastinitis allowed management of the fistula by percutaneous drainage-lavage and antibiotic therapy with subsequent closure of the esophageal wall defect and recovery from sepsis. This observation indicates that minimally invasive management of an esophageal perforation complicated by an esophago-pleural fistula is possible in highly selected patients.
authors.affiliation: Unité de Chirurgie OEso-Gastro-Duodénale, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, B-1200 Bruxelles, Belgique.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Mabrut
authors.forename: Patrick
authors.initials: P
authors.lastname: Druez
authors.forename: Louis
authors.initials: L
authors.lastname: Goncette
authors.forename: René
authors.initials: R
authors.lastname: Fiasse
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Collard
mesh_terms: D004322:Drainage; D004937:Esophageal Fistula / Q000209:etiology / Q000628:therapy*; D004939:Esophageal Perforation / Q000150:complications* / Q000209:etiology; D004932:Esophageal and Gastric Varices / Q000628:therapy; D004945:Esophagoscopy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000209:etiology / Q000628:therapy*; D016156:Respiratory Tract Fistula / Q000209:etiology / Q000628:therapy*; D015911:Sclerotherapy / Q000379:methods; D007507:Therapeutic Irrigation