Iatrogenic esophageal injuries: Evidence-based management for diagnosis and timing of contrast studies after repair

Ellen Ko, A. H. O-Yurvati

Research output: Contribution to journalReview article

2 Scopus citations

Abstract

Leakage from gastroesophageal repair is considered a major complication and is often associated with increased hospital stay, morbidity, and mortality. Management of these patients is variable among surgeons. Cases managed by the thoracic surgical service from March 1, 2010 to March 1, 2011 were retrospectively reviewed. Eight patients met criteria for inclusion: 4 were repaired primarily, 2 by debridement with diversion, and 2 by Ivor- Lewis resection and reconstruction. Esophograms were completed between 1 and 7 days postoperatively. Of the 8 patients treated, there was 1 mortality (12%) due to fungal mediastinitis. Soluble contrast imaging revealed 2 leaks (25%), 1 contained and 1 diffuse, which was the only mortality. Changes in clinical status, even minor, require contrast imaging of the esophagus to assess repair integrity. Timing of contrast study is variable in the literature, averaging 5 to 14 days. A conservative time frame is 7 days, unless any clinical suspicion of an esophageal leak exists.

Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalInternational Surgery
Volume97
Issue number1
DOIs
StatePublished - 1 Jan 2012

Keywords

  • Esophagus
  • Esophogram
  • Perforation

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