Unusual cause of esophageal perforation during intraoperative transesophageal echocardiography monitoring for cardiac surgery--a case report.

Acta anaesthesiologica Sinica Pub Date : 2003-09-01
Ming-Wen Pong, Su-Man Lin, Sheng-Chin Kao, Chi-Chun Chu, Chien-Kun Ting, Shen-Kou Tsai
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Abstract

Although esophageal perforation after transesophageal echocardiographic (TEE) examination is rare yet the occurrence of this life-threatening complication is increasing. We report an unusual esophageal perforation occurring 4 days after coronary artery bypass graft surgery and Bentall's procedure. The perforation was due to inadvertent injury of the esophagus that was deformed and distorted by a large calcified lymph node in the mediastinum during intraoperative TEE instrumentation. We suggest that careful preoperative radiological examination of the mediastinum should be done to recognize the anatomical pathology in patient whose routine chest X-ray has disclosed a large calcified lymph node in the mediastinum, if he happens to undergo TEE, so as to avoid disastrous esophageal perforation.

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术中经食管超声心动图监测中食管穿孔异常原因1例报告。
虽然经食管超声心动图(TEE)检查后的食管穿孔是罕见的,但这种危及生命的并发症的发生正在增加。我们报告一例不寻常的食管穿孔发生在冠状动脉搭桥术和本特尔手术后4天。穿孔是由于术中TEE内固定时纵隔的一个大的钙化淋巴结导致食管变形和扭曲而造成的意外损伤。我们建议,对于胸片常规显示纵隔有较大钙化淋巴结的患者,如果碰巧行TEE,术前应仔细进行纵隔影像学检查,以识别解剖病理,避免灾难性的食管穿孔。
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