Esophageal perforation during gastric bypass: delayed diagnosis and management.
Mediastinitis secondary to esophageal perforation is usually a life-threatening problem associated with high morbidity and mortality. We present a 44-year-old morbidly obese female who underwent laparoscopic gastric bypass, during which she suffered perforation of the distal thoracic esophagus diagnosed 5 days later during progression of mediastinitis. She was treated with left posterolateral thoracotomy, drainage of a peri-esophageal abscess and primary repair of the esophagus with intercostal muscle reinforcement, and cervical esophagostomy. Thereafter, she had an uneventful hospital course, and remains well on 12-month follow-up.
Endara
Santiago A
SA
Department of General Surgery, Division of Cardiothoracic Surgery, Hospital Metropolitano, Quito, Ecuador. santiagoendara@yahoo.com
Serrano
Armando J
AJ
Sandoval
Bernardo A
BA
Davalos
Gerardo A
GA
D000328:Adult; D004939:Esophageal Perforation / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D009767:Obesity, Morbid / Q000601:surgery*