RESUMO
Perforation of the cervical esophagus in the course of attempted intubation of the trachea is a very rare accident, or at least rarely reported. Over the past 11 years, 12 patients ranging in age from 44 to 72 years were treated in our unit. If suspected, esophageal perforation is easy to diagnose when intubation has been difficult or when the patient complains of dysphagia and neck pain. Subcutaneous cervical emphysema appears early. All the patients who were operated upon early made an uneventful and prompt recovery. In those subjected to delayed operation (more than 12 hours) or nonoperative treatment, the mortality rate was 56 percent and recovery was achieved only after long and difficult treatment.
Assuntos
Perfuração Esofágica/etiologia , Intubação Intratraqueal/efeitos adversos , Adulto , Idoso , Anestesia Endotraqueal , Drenagem , Perfuração Esofágica/diagnóstico por imagem , Perfuração Esofágica/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Mortalidade , Complicações Pós-Operatórias , Radiografia , Enfisema Subcutâneo/etiologiaAssuntos
Hiperparatireoidismo Secundário/cirurgia , Hiperparatireoidismo/cirurgia , Adolescente , Adulto , Idoso , Anestesia/métodos , Feminino , Humanos , Hiperparatireoidismo/etiologia , Masculino , Pessoa de Meia-Idade , Neoplasias das Paratireoides/complicações , Neoplasias das Paratireoides/cirurgia , Paris , Cuidados Pós-Operatórios , Complicações Pós-Operatórias , Pré-Medicação , Cuidados Pré-Operatórios , Estudos RetrospectivosRESUMO
On the basis of 12 cases of caustic burns of the oesophagus, the authors describe the technique of alimentation, once the acute phase of the first eight days has passed. From the 8th to the 15th days, calories and provided parenterally. An upper GI series is carried out on the 15th day: if the stomach is healthy, the authors fashion an alimentation gastrostomy, if the stomach is damaged, they carry out gastrectomy with alimentation gastrostomy or jejunostomy. In all cases, continuity is re-established by coloplasty two months later.
Assuntos
Cáusticos/intoxicação , Estenose Esofágica/terapia , Estenose Esofágica/induzido quimicamente , Estenose Esofágica/dietoterapia , Gastrectomia , Gastrostomia , Humanos , Infusões Parenterais , Jejuno/cirurgia , Gastropatias/induzido quimicamente , Gastropatias/cirurgia , Fatores de TempoRESUMO
The authors underline the factors favouring perforation of the oesophagus during intubation in the light of 12 personal cases: difficulty in intubation, use of an introducer, inexperienced operator. Such a perforation may result in mediastinitis and should be treated early with massive polyvalent antibiotics and a surgical suture left at rest for approximately one week.