A case of esophageal perforation after intraoperative transesophageal echocardiography in a patient with a giant left atrium: unexpectedly large distortion of the esophagus revealed on retrospectively constructed three-dimensional imaging.

Esophageal perforation Giant left atrium Mitral stenosis Transesophageal echocardiography

Journal

JA clinical reports
ISSN: 2363-9024
Titre abrégé: JA Clin Rep
Pays: Germany
ID NLM: 101682121

Informations de publication

Date de publication:
15 Mar 2019
Historique:
received: 26 12 2018
accepted: 05 03 2019
entrez: 7 2 2020
pubmed: 7 2 2020
medline: 7 2 2020
Statut: epublish

Résumé

Esophageal perforation is a rare but serious complication of transesophageal echocardiography (TEE). An enlarged left atrium (LA), which is commonly associated with mitral stenosis (MS), is an under-recognized risk factor for esophageal perforation after intraoperative TEE. We describe a case of TEE-induced esophageal perforation after cardiac surgery in a 79-year-old woman with a giant LA due to MS. Esophageal perforation was detected on postoperative day 6. After surgical repair, the patient gradually recovered with prolonged conservative treatment. Retrospectively constructed three-dimensional chest computed tomography images revealed an unusually distorted esophagus that was possibly vulnerable to injury. A giant LA can markedly distort the esophagus. It should be recognized as a risk factor for TEE-induced esophageal perforation.

Sections du résumé

BACKGROUND BACKGROUND
Esophageal perforation is a rare but serious complication of transesophageal echocardiography (TEE). An enlarged left atrium (LA), which is commonly associated with mitral stenosis (MS), is an under-recognized risk factor for esophageal perforation after intraoperative TEE.
CASE PRESENTATION METHODS
We describe a case of TEE-induced esophageal perforation after cardiac surgery in a 79-year-old woman with a giant LA due to MS. Esophageal perforation was detected on postoperative day 6. After surgical repair, the patient gradually recovered with prolonged conservative treatment. Retrospectively constructed three-dimensional chest computed tomography images revealed an unusually distorted esophagus that was possibly vulnerable to injury.
CONCLUSION CONCLUSIONS
A giant LA can markedly distort the esophagus. It should be recognized as a risk factor for TEE-induced esophageal perforation.

Identifiants

pubmed: 32026085
doi: 10.1186/s40981-019-0243-0
pii: 10.1186/s40981-019-0243-0
pmc: PMC6966746
doi:

Types de publication

Journal Article

Langues

eng

Pagination

21

Références

Interact Cardiovasc Thorac Surg. 2010 Sep;11(3):380-2
pubmed: 20494972
Anesthesiology. 2006 Dec;105(6):1273-4
pubmed: 17122591
J Am Soc Echocardiogr. 2013 Sep;26(9):921-64
pubmed: 23998692
Anesth Analg. 2001 May;92(5):1126-30
pubmed: 11323333
Can J Anaesth. 2008 Sep;55(9):622-47
pubmed: 18840593
Anesth Analg. 2004 Jul;99(1):41-4
pubmed: 15281500
Br J Anaesth. 2002 Apr;88(4):592-4
pubmed: 12066741
J Med Case Rep. 2016 Dec 1;10(1):338
pubmed: 27906089
Br J Anaesth. 2000 May;84(5):643-6
pubmed: 10844846
Anesthesiology. 2010 May;112(5):1084-96
pubmed: 20418689
J Am Soc Echocardiogr. 2005 Sep;18(9):925-9
pubmed: 16153515
Echocardiography. 2013 Sep;30(8):977-83
pubmed: 23834425

Auteurs

Aya Kimura (A)

Department of Anesthesiology, Osaka City University Graduate School of Medicine, 1-5-7, Asahi-Machi, Abeno-Ku, Osaka, 545-8586, Japan. aya1226kimura@gmail.com.

Takashi Mori (T)

Department of Anesthesiology, Osaka City University Graduate School of Medicine, 1-5-7, Asahi-Machi, Abeno-Ku, Osaka, 545-8586, Japan.

Yuki Kihara (Y)

Department of Anesthesiology, Osaka City University Graduate School of Medicine, 1-5-7, Asahi-Machi, Abeno-Ku, Osaka, 545-8586, Japan.

Chie Watanabe (C)

Department of Anesthesiology, Osaka City University Graduate School of Medicine, 1-5-7, Asahi-Machi, Abeno-Ku, Osaka, 545-8586, Japan.

Katsuaki Tanaka (K)

Department of Anesthesiology, Osaka City University Graduate School of Medicine, 1-5-7, Asahi-Machi, Abeno-Ku, Osaka, 545-8586, Japan.

Tokuhiro Yamada (T)

Department of Anesthesiology, Osaka City University Graduate School of Medicine, 1-5-7, Asahi-Machi, Abeno-Ku, Osaka, 545-8586, Japan.

Atushi Yoshida (A)

Department of Nuclear Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.

Joji Kawabe (J)

Department of Nuclear Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.

Yoshito Sakon (Y)

Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Toshihiko Sibata (T)

Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Kiyonobu Nishikawa (K)

Department of Anesthesiology, Osaka City University Graduate School of Medicine, 1-5-7, Asahi-Machi, Abeno-Ku, Osaka, 545-8586, Japan.

Classifications MeSH