Endoluminal Vacuum Therapy for Iatrogenic Perforation of the Proximal Oesophagus

 

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Abstract

Iatrogenic perforation of the upper gastrointestinal tract is one of the most serious complications of upper gastrointestinal endoscopy, with high rates of morbidity and mortality. Treatment is challenging because stent placement or surgical repair of the perforation in this area is often impossible. We report on two cases of iatrogenic perforations of the very proximal oesophagus and distal hypopharynx which could be successfully closed by using an endoluminal vacuum sponge treatment for 5 days. Thus, the endoluminal vacuum therapy may be a useful alternative to surgery in such cases of difficultly managable perforations of the upper oesophagus.

Zusammenfassung

Hochsitzende Perforationen des Ösophagus stellen eine schwer behandelbare Komplikation im Rahmen endoskopischer oder lokaler Eingriffe dar. Stentimplantationen kommen in der Regel nicht infrage und operative Sanierungen sind aufwendig. Wir berichten von 2 Fällen einer iatrogenen Perforation des proximalen Ösophagus und distalen Hypopharynx mit Mediastinitis und Hautemphysem. In beiden Fällen konnte durch eine 5-tägige intraluminale Vakuumtherapie mit dem EndoSponge-System eine komplette Ausheilung der Perforationen erzielt werden. Die endoluminale Vakuumtherapie scheint somit eine nützliche Alternative zur Operation bei diesen allgemein schwer behandelbaren proximalen Ösophagusperforationen zu sein.

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