Abstract

ANTEZANA, Walter et al. Esophagic perforation. Gac Med Bol [online]. 2008, vol.31, n.1, pp.50-54. ISSN 1012-2966.

The esophagic perforation is a pathology that demands a high diagnostic suspition because the delay in the surgical treatment increases the morbid­morthality with a rate of 40­50% if the treatment is done after 24 hours, the mediasthinitis is the responsible of the severity of this case. We present a case of a 47 year old male who initially was treated in another hospital with the diagnosis of upper digestive hemorrage submitted to endoscopic procedure with further complication of his case. He was transferred to our hospital with the diagnosis of congestive cardiac failure, heart tamponade and chest pain, dysnea, low blood pressure, bilateral yugular ingurgitation. Ecocardiography reports efussion pleural and pericardic masive. A pericardic window was done as well as a pleurostomy, the evolution shows debit purulento through the pleurostomy. Completed all the studies the final diagnosis was esophagic perforation (90% of the circumference) in the tercio distal. A gastric­esophagus anasthomosis was done with a circular stappler, gastric suture, after the first surgery appears a dehiscence of the suture. He went through surgery again to close the dehiscence, after this procedure the evolution was satisfactory. He left the hospital in good conditions with oral feed.

Keywords : Esophagic perforation; mediasthinitis; endoscopic equipment.

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