Laparosc Endosc Surg Sci . 2019; 26(1): 28-31 | DOI: 10.14744/less.2019.09609

Endoscopic treatment of esophageal perforation and paraesophageal abscess formation due to foreign body impaction

Erkan Oymaci¹, Nurettin Kahramansoy², Sedat Tan², Burak Dede², Mehmet Yýldýrým^2
1University of Health Sciences Izmir Bozyaka Education And Research Hospital, Gastroenterology Surgery Department, Izmir
²University of Health Sciences Izmir Bozyaka Education And Research Hospital, General Surgery Department, Izmir

Although foreign bodies located in the esophagus are not frequently encountered, it is a problem that can cause serious morbidity and mortality, especially if a perforation has occurred. Flexible endoscopy is the preferred therapeutic option for removing foreign bodies in cases of perforation due to its high success rate and low risk of complications. Presently described is the case of a 65-year-old female who was admitted to the hospital with an impacted esophageal foreign body, which was revealed to be a meat bone that had perforated the esophageal wall, accompanied by a paraesophageal abscess formation. Flexible endoscopy was performed in the operating room under general anesthesia and the esophageal foreign body was gently removed with rat tooth forceps and a snare. Purulent abscess fluid was drained from the esophageal perforation site and aspirated through the endoscope. The perforation site in the esophageal mucosa was about 1 centimeter in size and was closed with an endoscopic hemoclip. Perforation due to esophageal foreign bodies may lead to clinical conditions with serious mortality and morbidity. Endoscopic procedures performed by an experienced endoscopist may be appropriate in selected cases and avoid a major surgical operation.

Keywords: Esophageal perforation, esophageal foreign body, paraesophageal abscess, endoscopy

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Yabancý cisime baðlý özefagus perforasyonu ve paraözefajial absenin endoskopik yaklaþým ile tedavisi

Erkan Oymaci¹, Nurettin Kahramansoy², Sedat Tan², Burak Dede², Mehmet Yýldýrým^2
1Saðlýk Bilimleri Üniversitesi Ýzmir Bozyaka Eðitim ve Araþtýrma Hastanesi, Gastroenteroloji Cerrahisi, Ýzmir
²Saðlýk Bilimleri Üniversitesi Ýzmir Bozyaka Eðitim Ve Araþtýrma Hastanesi, Genel Cerrahi Kliniði, Ýzmir

Özefagusda yerleþen yabancý cisimler sýk karþýlaþýlmamakla birlikte, beraberinde özellikle perforasyon da mevcut ise, ciddi morbidite ve mortaliteye neden olabilen bir sorun olarak karþýmýza çýkmaktadýr. Esnek endoskopi, perforasyon durumunda yabancý cisimleri çýkarmak için terapötik bir seçenektir ve yüksek baþarý oraný ve düþük komplikasyon riski nedeniyle tercih edilir. Yutulamamýþ bir kemik parçasýnýn özefagusda takýlarak perforasyon ve paraözefajial abse oluþumuna neden olmuþ ve kliniðimizde endoskopik olarak teþhis, tedavi edilen 65 yaþýnda kadýn hastayý sunduk. Ameliyathane þartlarýnda genel anestezi altýnda hastaya endoskopi uygulandý ve özefagusdaki yabancý cisim fare diþli forseps ve snare ile çýkarýldý. Özefagusdaki perforasyon alanýndan pürülan nitelikte abse drenajý gözlendi ve endoskop ile aspire edildi. Özefagus mukozasýndaki yaklaþýk 1 cm’lik perforasyon endoskopik klipsler ile kapatýldý. Özofagus yabancý cisimlerinden kaynaklanan perforasyonlar ciddi mortalite ve morbiditeye sahip klinik durumlar oluþturabilir. Deneyimli endoskopist tarafýndan gerçekleþtirilen endoskopik prosedürler, seçilmiþ olgularda büyük cerrahi bir ameliyat gerekmeksizin uygun olabilir.

Anahtar Kelimeler: Özefagus perforasyonu, özefagus yabancý cisim, paraözefajial abse, endoskopi

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