title: Delayed presentation of intrathoracic esophageal perforation after pneumatic dilation for achalasia.
abstract: Pneumatic dilation (PD) is considered to be a safe and effective first line therapy for achalasia. The major adverse event caused by PD is esophageal perforation but an immediate gastrografin test may not always detect a perforation. It has been reported that delayed management of perforation for more than 24 h is associated with high mortality. Surgery is the treatment of choice within 24 h, but the management of delayed perforation remains controversial. Hereby, we report a delayed presentation of intrathoracic esophageal perforation following PD in a 48-year-old woman who suffered from achalasia. She completely recovered after intensive medical care. A review of the literature is also discussed.
authors.affiliation: Division of Hepatogastroenterology, Chang Gang Memorial Hospital, Niaosung Hsiang, Kaohsiung Country 833, Taiwan, China.
authors.forename: Ming-Tzung
authors.initials: MT
authors.lastname: Lin
authors.forename: Wei-Chen
authors.initials: WC
authors.lastname: Tai
authors.forename: King-Wah
authors.initials: KW
authors.lastname: Chiu
authors.forename: Yeh-Pin
authors.initials: YP
authors.lastname: Chou
authors.forename: Ming-Chao
authors.initials: MC
authors.lastname: Tsai
authors.forename: Tsung-Hui
authors.initials: TH
authors.lastname: Hu
authors.forename: Chuan-Mo
authors.initials: CM
authors.lastname: Lee
authors.forename: Chi-Sin
authors.initials: CS
authors.lastname: Changchien
authors.forename: Seng-Kee
authors.initials: SK
authors.lastname: Chuah
mesh_terms: D002404:Catheterization / Q000009:adverse effects*; D002637:Chest Pain / Q000209:etiology; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods; D004931:Esophageal Achalasia / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D004939:Esophageal Perforation / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome