Endoscopy 2018; 50(04): S142
DOI: 10.1055/s-0038-1637457
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC TREATMENT OF DELAYED FOREIGN BODY ESOPHAGEAL PERFORATION

OV Hernández Mondragón
1   IMSS, Endoscopy Department, Mexico, Mexico
,
D Espinosa Saavedra
1   IMSS, Endoscopy Department, Mexico, Mexico
,
JM Blancas Valencia
1   IMSS, Endoscopy Department, Mexico, Mexico
,
LA Lopez Valenzuela
1   IMSS, Endoscopy Department, Mexico, Mexico
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

 

This is the case of a 61 years-old male whit a past medical history of type 2 diabetes, systemic arterial hypertension and ischemic hearth disease on medical treatment and well controlled.

Seven days before hospitalization, he presented an accidental foreign body ingestion of a chicken bone, after this he presented with dysphagia, and pain at the level of the neck. In emergency department the vital signs were normal and no emphysema or signs of perforation were detected.

The CT scan reconstruction showed an foreign body below the cricoid cartilage but that exceeded the esophageal limit, suggesting a controlled esophageal perforation.

Upper endoscopy was done and the foreign bone was extracted, and the mucosal defect showed purulent content. We used a cytology brush and combined with water, we did an intense lavage of this zone. We could confirm the esophageal perforation at this site, so we decided to irrigate with gentamicin inside the defect and after this we performed an endoscopic closure with mechanical clips and because of difficulties in closure of this defect because of the time (7 days after initial ingestion of foreign boy), we decided to put cyanoacrylate in this zone.

Barium esophagram test showed no lead and only the correct clips placement. Finally, patient was discharged 48 hours after procedure without signs of complication.

Conclusion:

Endoscopic treatment could be an excellent option in case of foreign body patients who doesn't show any sign of systemic infection. In fact local infection could be treated only endoscopically including closure of defect without need of more aggressive approaches.