title: Esophageal tear in a patient undergoing stereotactic brain biopsy under general anesthesia.
abstract: Injuries of the esophagus with resultant mediastinitis have been reported following endotracheal intubation. Herein, we report a case of esophageal perforation that resulted from difficulty with intubation in a patient with a stereotactic head frame. A 52-year-old woman underwent a stereotactic brain biopsy of a left temporal tumor. After a stereotactic head frame was applied, intubation for anesthesia required three attempts. On postoperative day 2, she complained of worsening dysphagia and chest pain. A 4-mm tear in the right posterior cervical esophagus was discovered and repaired. Esophageal perforation may arise from limited neck extension imposed by a stereotactic head frame. Unexplained dysphagia postoperatively is the hallmark of this rare complication.
authors.affiliation: Department of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Jason E
authors.initials: JE
authors.lastname: York
authors.forename: Robert E
authors.initials: RE
authors.lastname: Wharen
authors.forename: Eric L
authors.initials: EL
authors.lastname: Bloomfield
mesh_terms: D000768:Anesthesia, General; D000771:Anesthesia, Intravenous; D001706:Biopsy / Q000009:adverse effects*; D001921:Brain / Q000601:surgery*; D001932:Brain Neoplasms / Q000473:pathology; D002637:Chest Pain / Q000209:etiology; D003680:Deglutition Disorders / Q000209:etiology; D004322:Drainage; D017029:Epilepsy, Complex Partial / Q000209:etiology / Q000473:pathology; D004947:Esophagus / Q000293:injuries* / Q000601:surgery*; D005260:Female; D005910:Glioma / Q000473:pathology; D006801:Humans; D007431:Intraoperative Complications / Q000601:surgery*; D008482:Mediastinum / Q000601:surgery; D008875:Middle Aged; D013238:Stereotaxic Techniques / Q000009:adverse effects*; D013908:Thoracotomy
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