HomeArchiveVolume 7Volume 7, issue 1Esophageal perforation due to acute esophageal necrosis: A case report and a comprehensive literature review
Petrola C. Chacón1, Castro S. Boix2, Nivardo R. Conde2, Gantxegi A. Madina2, Mariona Jofra2, Gil D. Sala3, Armengol M. Carrasco1
1GENERAL AND DIGESTIVE SURGERY DEPARTMENT. VALL D´HEBRON HOSPITAL UNIVERSITARI. UNIVERSITAT AUTONÒMA DE BARCELONA. BARCELONA, SPAIN
2UPPER GI SURGERY DIVISION. GENERAL AND DIGESTIVE SURGERY DEPARTMENT. VALL D 'HEBRON HOSPITAL UNIVERSITARI. UNIVERSITAT AUTÒNOMA DE BARCELONA. BARCELONA, SPAIN
3ANGIOLOGY AND VASCULAR SURGERY DEPARTMENT. VALL D'HEBRON HOSPITAL UNIVERSITARI. UNIVERSITAT AUTÒNOMA DE BARCELONA. BARCELONA, SPAIN
Abstract
Background. Acute esophageal necrosis is a rare and potentially lethal entity. The pathogenesis is multifactorial, generally presenting with symptoms of upper gastrointestinal bleeding. We present a case that presents atypically with initial esophageal perforation. Case presentation. A 46-year-old man with a history of alcoholism and cocaine use, an active smoker, and a ruptured celiac trunk aneurysm treated by embolization, who, after acute chest and epigastric pain, is diagnosed with a Stanford B thoracoabdominal aortic dissection, being repaired endovascularly by placing an aortic endoprosthesis. Due to clinical suspicion of mesenteric ischemia complicated with esophageal/gastric perforation, a postoperative tomography was performed, revealing perforation of the esophagus distal to the left pleura and ischemic cholecystitis. Transhiatal esophagectomy, cervical esophagostomy, Witzel-type decompressive gastrostomy, Witzel-type feeding jejunostomy, classic cholecystectomy, and mediastinum drainage were performed. During the postoperative period, the patient remained in critical condition, dying as a result of hypoxic encephalopathy. The histopathological study reported acute transmural esophageal ischemia. Discussion. Tissue hypoperfusion plays a dominant role in the pathogenesis of acute esophageal necrosis. Esophageal perforation is a serious complication and can occur in the early stages, with esophagectomy and deferred digestive reconstruction being the appropriate treatment. Conclusion. Ischemia is a fundamental mechanism of acute esophageal necrosis; its diagnosis must always be established in the various complications that may occur in patients with hemodynamic compromise, in order to obtain a timely treatment.
Cite this article:
Vancouver
Chacón PC, Boix CS, Conde NR, Madina GA, Jofra M, Sala GD, Carrasco AM. Esophageal perforation due to acute esophageal necrosis: A case report and a comprehensive literature review. J Clin Investig Surg. 2022 May 25; 7(1):104-108. Available from: https://www.proscholar.org/jcis/archive/vol.7/iss.1/18/ doi: 10.25083/2559.5555/7.1.18
NLM
Chacón PC, Boix CS, Conde NR, Madina GA, Jofra M, Sala GD, Carrasco AM. Esophageal perforation due to acute esophageal necrosis: A case report and a comprehensive literature review. J Clin Investig Surg. 2022 May;7(1):104-108. doi: 10.25083/2559.5555/7.1.18.
AMA
Chacón PC, Boix CS, Conde NR, Madina GA, Jofra M, Sala GD, Carrasco AM. Esophageal perforation due to acute esophageal necrosis: A case report and a comprehensive literature review. J Clin Investig Surg. 2022;7(1):104-108.
MLA
Chacón, Petrola C., et al. “Esophageal perforation due to acute esophageal necrosis: A case report and a comprehensive literature review.” Journal of Clinical and Investigative Surgery 7.1 (2022): 104-108. doi:10.25083/2559.5555/7.1.18.
APA
Chacón, P. C., Boix, C. S., Conde, N. R., Madina, G. A., Jofra, M., Sala, G. D., & Carrasco, A. M. (2022). Esophageal perforation due to acute esophageal necrosis: A case report and a comprehensive literature review. Journal of Clinical and Investigative Surgery, 7(1), 104-108.
ISO 690
Chacón
, Petrola C., et al. Esophageal perforation due to acute esophageal necrosis: A case report and a comprehensive literature review. Journal of Clinical and Investigative Surgery, 2022, 7.1: 104-108.