Thoracoscopic treatment of barium-induced lung entrapment complicating esophageal perforation.
Patients with suspected esophageal perforations are routinely evaluated with a swallow study using a water-soluble contrast medium followed by thin-barium administration when the first fails to demonstrate a leak. Intrapleural barium instillation has been historically correlated with mild degree of pleural inflammation and a low-grade talclike reactive process. Still, if administered in excessive quantities, it may contribute to complicate the clinical scenario of pleural contamination secondary to the perforated esophagus. We report the case of a patient that presented with a malignant esophageal perforation and developed a trapped lung from extensive pleural contamination with barium sulfate that required video-assisted thoracic drainage and decortication with successful reexpansion of the lung and resolution of the acute symptoms.
Palazzo
Francesco
F
Department of Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA. Francesco.Palazzo@mail.tju.edu
Silvestry
Scott C
SC
D001466:Barium Sulfate / Q000009:adverse effects*; D003287:Contrast Media; D004938:Esophageal Neoplasms / Q000150:complications*; D004939:Esophageal Perforation / Q000150:complications* / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008171:Lung Diseases / Q000139:chemically induced* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020775:Thoracic Surgery, Video-Assisted / Q000295:instrumentation / Q000379:methods
D003287:Contrast Media; D001466:Barium Sulfate