[Drainage-lavage and closure of a late esophageal perforation with esophagopleural fistula and encysted pleural effusion after endoscopic injection sclerotherapy for varices].
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.
Mabrut
Jean-Yves
JY
Unité de Chirurgie OEso-Gastro-Duodénale, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, B-1200 Bruxelles, Belgique.
Druez
Patrick
P
Goncette
Louis
L
Fiasse
René
R
Collard
Jean-Marie
JM
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