Yan Zhang1, Ping Lu. 1. Department of Otorhinolaryngology, Third Hospital, Wuhan, 430060, China.
Abstract
OBJECTIVE: To explore the countermeasure to reduce fatality in patients with intrathoracic oesophageal perforation caused by foreign body. METHOD: Exploratory pleuracotomy were operated on all the 12 cases with intrathoracic esophageal perforation caused by foreign body. According to the different pathological morbids, one of following surgical procedures was operated: 1. esophagoscopy was used to fetch the foreign body and the oesophageal perforation was repaired (3 cases), 2. esophagotomy was adopted to fetch the foreign body and to had the oesophageal a drainage using "T" tube (5 cases), 3. esophagotomy was adopted to fetch the foreign body and to had the oesophageal a drainage using "T" tube as well jejunostomy (3 cases). Occlusive drainage were used on all the cases and pleuroclysis with flagyl soloution and normal saline were used on some cases. RESULT: Four of 12 cases (33.3%) were cured, the others (66.7%) died, among them 7 cases died of breaks of thoracaorta and hematorrhoea afterwards. CONCLUSION: An esophagoscopy to fetch the foreign body, the pleuracotomy to protect thoracaorta in time, preventing infection and hematorrhoea post-operation are keys in reduce the fatality in patients with intrathoracic oesophageal perforation caused by foreign body.
OBJECTIVE: To explore the countermeasure to reduce fatality in patients with intrathoracic oesophageal perforation caused by foreign body. METHOD: Exploratory pleuracotomy were operated on all the 12 cases with intrathoracic esophageal perforation caused by foreign body. According to the different pathological morbids, one of following surgical procedures was operated: 1. esophagoscopy was used to fetch the foreign body and the oesophageal perforation was repaired (3 cases), 2. esophagotomy was adopted to fetch the foreign body and to had the oesophageal a drainage using "T" tube (5 cases), 3. esophagotomy was adopted to fetch the foreign body and to had the oesophageal a drainage using "T" tube as well jejunostomy (3 cases). Occlusive drainage were used on all the cases and pleuroclysis with flagyl soloution and normal saline were used on some cases. RESULT: Four of 12 cases (33.3%) were cured, the others (66.7%) died, among them 7 cases died of breaks of thoracaorta and hematorrhoea afterwards. CONCLUSION: An esophagoscopy to fetch the foreign body, the pleuracotomy to protect thoracaorta in time, preventing infection and hematorrhoea post-operation are keys in reduce the fatality in patients with intrathoracic oesophageal perforation caused by foreign body.
Authors: Andrej Udelnow; Markus Huber-Lang; Markus Juchems; Karl Träger; Doris Henne-Bruns; Peter Würl Journal: World J Surg Date: 2009-04 Impact factor: 3.352