title: Successful endoscopic hemoclipping of an esophageal perforation.
abstract: We describe a case of esophageal perforation that resulted from a fishbone. A 71-year-old man had had a fishbone impacted in the lower esophagus for 2 days. At presentation, the bone was dislodged at endoscopy; one round opening in a deep ulceration was detected when the fishbone was removed. The perforation was closed by endoscopic hemoclipping, after the removal of the fishbone. A thoracic computed tomography revealed air around the esophagus, aorta and bronchus and the presence of a pleural effusion. These findings suggested mediastinal emphysema and mediastinitis due to the esophageal perforation after the removal of the fishbone. Esophagography revealed a focal esophageal defect and linear contrast leakage at the distal esophagus. The mediastinal emphysema and pleural effusion successfully resolved after the endoscopic hemoclip application and conservative management of the perforation.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Catholic University of Korea, Seoul, Korea.
authors.forename: H Y
authors.initials: HY
authors.lastname: Sung
authors.forename: J I
authors.initials: JI
authors.lastname: Kim
authors.forename: D Y
authors.initials: DY
authors.lastname: Cheung
authors.forename: S H
authors.initials: SH
authors.lastname: Cho
authors.forename: S-H
authors.initials: SH
authors.lastname: Park
authors.forename: J-Y
authors.initials: JY
authors.lastname: Han
authors.forename: J K
authors.initials: JK
authors.lastname: Kim
authors.forename: S W
authors.initials: SW
authors.lastname: Han
authors.forename: K Y
authors.initials: KY
authors.lastname: Choi
authors.forename: I S
authors.initials: IS
authors.lastname: Chung
mesh_terms: D000368:Aged; D004939:Esophageal Perforation / Q000209:etiology / Q000628:therapy*; D005547:Foreign Bodies / Q000150:complications*; D016558:Hemostasis, Endoscopic / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000209:etiology / Q000628:therapy; D010996:Pleural Effusion / Q000209:etiology / Q000628:therapy