title: Thoracoscopic esophageal repair of a spontaneous Barrett's ulcer perforation.
abstract: Spontaneous esophageal perforation of a Barrett's ulcer is a rare condition that is associated with high morbidity and mortality. It occurs as a result of a missed diagnosis of underlying Barrett's esophagus or because of unresponsiveness to medical management. Owing to the life-threatening nature of this disease, emergency surgical intervention is indicated. Here, we report the first case of spontaneous Barrett's esophageal perforation that has been managed using a thoracoscopic approach. This case highlights the feasibility of minimally invasive methodology for emergent esophageal disorders. It also demonstrates the altered esophageal wall properties of Barrett's esophagus through musculofibrous thickening and muscularis mucosae duplication that may contribute to the technical outcomes of esophageal surgical management.
authors.affiliation: Northwick Park and St Mark's Hospitals, London, United Kingdom; Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
authors.forename: Hutan
authors.initials: H
authors.lastname: Ashrafian
authors.affiliation: Northwick Park and St Mark's Hospitals, London, United Kingdom.
authors.forename: Antonio
authors.initials: A
authors.lastname: Navarro-Sanchez
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
authors.forename: Thanos
authors.initials: T
authors.lastname: Athanasiou
authors.affiliation: Northwick Park and St Mark's Hospitals, London, United Kingdom.
authors.forename: David I
authors.initials: DI
authors.lastname: Sherman
authors.affiliation: Northwick Park and St Mark's Hospitals, London, United Kingdom. Electronic address: a.isla@imperial.ac.uk.
authors.forename: Alberto
authors.initials: A
authors.lastname: Isla
mesh_terms: D000368:Aged; D001471:Barrett Esophagus / Q000150:complications* / Q000601:surgery*; D004939:Esophageal Perforation / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000209:etiology* / Q000601:surgery*; D013906:Thoracoscopy; D004935:Esophageal Diseases; D012422:Rupture, Spontaneous; D000072663:Spontaneous Perforation