Koichiro Wasano1, Sayuri Hashiguchi2, Noriomi Suzuki2, Taiji Kawasaki2, Ichirota Nameki2, Hideo Nameki2. 1. Department of Otolaryngology, Head, and Neck Surgery Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan; Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan. Electronic address: wasano@a5.keio.jp. 2. Department of Otolaryngology, Head, and Neck Surgery Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan.
Abstract
OBJECTIVE: We present a case of pharyngeal perforation caused by gastrointestinal endoscopy that was successfully repaired with transoral mucosal sutures. This is the first report of a transoral surgical closure of a perforation caused by an endoscope. We describe the repair procedure, the necessary equipment, and the effectiveness of suturing pharyngeal perforations. PATIENT: An 87-year-old woman brought to our emergency department by ambulance because of hematemesis and endoscopic hemostasis was successfully performed. But after hemostasis, CT scan showed emphysema extending from the right lower jaw to the superior mediastinum and pharyngeal perforation was observed by laryngeal fiberscope. INTERVENTION: Even though she had received conservative treatment, exacerbation of inflammation was observed and therefore we performed transoral surgery for closing the pharyngeal perforation. MAIN OUTCOME MEASURE: We followed up with CT scans, blood test and vital signs. RESULTS: The pharyngeal perforation smoothly closed and exacerbation of inflammation was not observed, even after oral ingestion began. CONCLUSION: Transoral closure of a pharyngeal perforation is less invasive and performing this procedure at an early stage can lead to a favorable outcome.
OBJECTIVE: We present a case of pharyngeal perforation caused by gastrointestinal endoscopy that was successfully repaired with transoral mucosal sutures. This is the first report of a transoral surgical closure of a perforation caused by an endoscope. We describe the repair procedure, the necessary equipment, and the effectiveness of suturing pharyngeal perforations. PATIENT: An 87-year-old woman brought to our emergency department by ambulance because of hematemesis and endoscopic hemostasis was successfully performed. But after hemostasis, CT scan showed emphysema extending from the right lower jaw to the superior mediastinum and pharyngeal perforation was observed by laryngeal fiberscope. INTERVENTION: Even though she had received conservative treatment, exacerbation of inflammation was observed and therefore we performed transoral surgery for closing the pharyngeal perforation. MAIN OUTCOME MEASURE: We followed up with CT scans, blood test and vital signs. RESULTS: The pharyngeal perforation smoothly closed and exacerbation of inflammation was not observed, even after oral ingestion began. CONCLUSION: Transoral closure of a pharyngeal perforation is less invasive and performing this procedure at an early stage can lead to a favorable outcome.
Authors: Vivek Kumbhari; Alba A Azola; Alan H Tieu; Reetika Sachdeva; Payal Saxena; Ahmed A Messallam; Mohamad H El Zein; Patrick I Okolo; Mouen A Khashab Journal: Surg Endosc Date: 2014-08-23 Impact factor: 4.584
Authors: K J Dickinson; N Buttar; L M Wong Kee Song; C J Gostout; S D Cassivi; M S Allen; F C Nichols; K R Shen; D A Wigle; S H Blackmon Journal: Endosc Int Open Date: 2016-11-08