Perforation of Barrett's ulcer: a challenge in esophageal surgery.
Ann Thorac Surg
; 69(6): 1707-10, 2000 Jun.
Article
em En
| MEDLINE
| ID: mdl-10892911
ABSTRACT
BACKGROUND:
Barrett's ulcer, which develops within Barrett's esophagus, is frequently responsible for bleeding. Perforation is a rare complication constituting a great challenge for diagnosis and management.METHODS:
Three personal cases and 31 published reports of perforated Barrett's ulcer were reviewed retrospectively. The site of perforation, clinical presentation, management, and outcome were assessed.RESULTS:
The clinical presentation proved to be heterogeneous and was determined by the site of perforation this was the pleural cavity (20% of cases), mediastinum (20%), left atrium (16.6%), tracheobronchial tract (13.3%), aorta (13.3%), pericardium (10%), or pulmonary vein (6.6%). Early esophagectomy and esophageal diversion-exclusion were the most frequent procedures, and overall mortality was 45%.CONCLUSIONS:
The poor prognosis of perforated Barrett's ulcer should be improved by earlier diagnosis and adequate emergent operation. Although early esophagectomy constitutes the recommended procedure, esophageal diversion-exclusion, which allows control of both sepsis and bleeding, is also of interest.
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Base de dados:
MEDLINE
Assunto principal:
Úlcera
/
Esôfago de Barrett
/
Perfuração Esofágica
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2000
Tipo de documento:
Article