title: Esophageal perforation during esophagogastroduodenoscopy.
abstract: An esophageal perforation occurred during an esophagogastroduodenoscopy (EGD). The patient had an episode of retching and forceful vomiting just after an esophageal mucosal biopsy at the gastroesophageal junction. The only clinical feature demonstrated by the patient was neck crepitation after completion of the EGD. Initial evaluation of the referred patient by posterior and lateral chest x-rays revealed extensive pneumomediastinum with subcutaneous emphysema. A unique chest computed tomography scan demonstrated suspension of the esophageal mucosal surface and lumen in a "bull's eye" configuration. A water-soluble esophageal swallow followed by a thin liquid barium swallow demonstrated that the esophageal perforation had sealed. The patient completely recovered with conservative medical therapy of clear liquid diet and antibiotics.
authors.affiliation: East Cooper Medical Center, Mt Pleasant, SC, USA. DrMajeski@aol.com
authors.forename: James
authors.initials: J
authors.lastname: Majeski
authors.forename: William
authors.initials: W
authors.lastname: Lynch
authors.forename: George
authors.initials: G
authors.lastname: Durst
mesh_terms: D016145:Endoscopy, Digestive System / Q000009:adverse effects*; D004939:Esophageal Perforation / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000209:etiology; D008875:Middle Aged; D013352:Subcutaneous Emphysema / Q000209:etiology; D014057:Tomography, X-Ray Computed