scholarly journals A case of esophageal perforation: Clinical and diagnostic management in emergency medicine

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Marco Di Serafino ◽  
Maurizio Martorano ◽  
Pamela Delmonaco ◽  
Chiara Gullotto ◽  
Andrea Baglioni ◽  
...  
Keyword(s):  
Foreign Body ◽  
Esophageal Perforation ◽  
Delayed Diagnosis ◽  
Penetrating Trauma ◽  
Foreign Body Ingestion ◽  
Delay In Diagnosis ◽  
Diagnostic Management ◽  
Esophagus Perforation ◽  
Boerhaave Syndrome ◽  
Diagnostic Work

Esophageal perforation is a welldefined and severe clinical condition. The associated mortality rates range between 5% and 40% and are worsened by delayed diagnosis. Rapid diagnosis and therapy provide the best chance for survival; however, a delay in diagnosis is common, resulting in substantial morbidity and mortality. There are several aetiologies of esophagus perforation. Most esophageal ruptures are secondary to medical instrumentation. Other causes are Boerhaave syndrome, toxic ingestions and radiation, foreign body ingestion, penetrating trauma, and, rarely, blunt chest trauma. We reported the clinical management and the diagnostic work-up case of esophagus perforation due to the foreign body ingestion.

Management of Esophageal Perforation: 28-Year Experience in a Major Referral Center

2018 ◽  
Vol 84 (5) ◽  
pp. 684-689 ◽  
Author(s):  
Ana Puertavicente ◽  
Pablo Priego JimÉNez ◽  
María Ángeles Cornejo López ◽  
Francisca GarcÍA-Moreno Nisa ◽  
Gloria RodrÍGuez Velasco ◽  
...  
Keyword(s):  
Esophageal Perforation ◽  
Severe Disease ◽  
Treatment Options ◽  
Delayed Diagnosis ◽  
Mortality Rates ◽  
Endoscopic Management ◽  
High Morbidity ◽  
Septic Complications ◽  
Delay In Diagnosis ◽  
Individualized Approach

Esophageal perforation constitutes a surgical emergency. Despite its gravity, no single strategy has been described as sufficient to deal with most situations to date. The aim of this study was to assess the etiology, management, and outcome of esophageal perforation over a 28-year period, to characterize optimal treatment options in this severe disease. A retrospective clinical review of all patients treated for esophageal perforation at Ramón y Cajal Hospital between January 1987 and December 2015 was performed (n = 57). Iatrogenic injury was the most frequent cause of esophageal perforation (n = 32). Abdominal esophagus was the main location (23 patients; 40.4%). Eight patients (14%) were managed with antibiotics and parenteral nutrition. In seven patients (12.3%), an endoscopic stent was implanted. Surgical therapy was performed in 38 patients (66.7%). Morbidity and 90-day mortality rates were 61.4 and 28 per cent, respectively. Five patients were reoperated (8.8%). Median hospital stay was 23.5 days. The mortality rate was higher among patients with spontaneous and tumoral perforation (54.5 and 100%; P = 0.009), delayed diagnosis (>24 hours; P = 0.0001), and abdominal/thoracic location (37.5%; P = 0.05). No statistical differences were found between surgical and conservative/endoscopic management (31% vs 20%; P = 0.205) although hospital staying was longer in surgical group (36.30 days vs 15.63 days; P = 0.029). Esophageal perforation was associated with high morbidity and mortality rates. Global outcomes depend on etiology, site of perforation, and delay in diagnosis. An individualized approach for each patient should be chosen to prevent septic complications of this potentially fatal disease.

Delayed diagnosis of laryngeal foreign body

2003 ◽  
Vol 117 (2) ◽  
pp. 143-144 ◽  
Author(s):  
W. V. Jesudason ◽  
D. A. Luff ◽  
M. P. Rothera
Keyword(s):  
Foreign Body ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Foreign Bodies ◽  
Clinical Presentation ◽  
Delayed Diagnosis ◽  
Accidental Death ◽  
Delay In Diagnosis

Aspiration of a foreign body is a recognized cause of accidental death in children. Paediatricians are aware of the symptoms of inhaled foreign bodies in the lower respiratory tract. However, symptoms which suggest impaction in the larynx do not appear to raise the same index of suspicion of a foreign body. One case of laryngeal foreign body is described with a delay in diagnosis of five days. The clinical presentation, investigations and management are discussed.

Asymptomatic esophageal perforation after foreign body ingestion

2005 ◽  
Vol 61 (4) ◽  
pp. 615-619 ◽  
Author(s):  
Rogelio G. Silva ◽  
Jatinder P. Ahluwalia
Keyword(s):  
Foreign Body ◽  
Esophageal Perforation ◽  
Foreign Body Ingestion

scholarly journals Management of esophageal perforation with fistula formation in an 80 year old woman with multiple co-morbidities

2021 ◽  
Vol 7 (5) ◽  
pp. 882
Author(s):  
Jalal Almarzooq ◽  
Ayman Alkhabbaz ◽  
Nabeel Abdulla
Keyword(s):  
Foreign Body ◽  
Conservative Management ◽  
Esophageal Perforation ◽  
Open Surgery ◽  
Surgical Intervention ◽  
Fish Bone ◽  
Foreign Body Ingestion ◽  
Fistula Formation

<p class="abstract">Esophageal perforation due to foreign body ingestion may lead to serious complications. Here we present a case of an 80 year old lady with multiple co-morbidities who presented with a proximal esophageal perforation with fistula formation following ingestion of a fish bone. Due to her age and co-morbidities the decision was made to manage her conservatively by IV antibiotics, NG tube feeds and observation. Follow up after 2 months showed resolution of the perforation and fistula, without the patient needing any surgical intervention. This case highlights conservative management of esophageal perforation with complications in patients with co-morbidities where open surgery is not favoured.</p>

Foreign Body Ingestion and Aspiration : A Review of Characteristics in Child and Adult Cases

2008 ◽  
Vol 59 (2) ◽  
pp. 195-195
Author(s):  
Y. Oka ◽  
K. Asabe ◽  
H. Kai ◽  
T. Shirakusa
Keyword(s):  
Foreign Body ◽  
Foreign Body Ingestion

scholarly journals Younger age of onset and uveitis associated with HLA-B27 and delayed diagnosis in Thai patients with axial spondyloarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Naphruet Limsakul ◽  
Praveena Chiowchanwisawakit ◽  
Parichart Permpikul ◽  
Yubolrat Thanaketpaisarn
Keyword(s):  
Regression Analysis ◽  
Multiple Regression Analysis ◽  
Axial Spondyloarthritis ◽  
Age At Onset ◽  
Delayed Diagnosis ◽  
Musculoskeletal Symptom ◽  
Hla B27 ◽  
Delay In Diagnosis ◽  
Factors Associated ◽  
Younger Age

AbstractTo identify characteristics associated with HLA-B27, and to identify factors associated with delayed diagnosis in Thai patients with axial spondyloarthritis (axSpA). This cross-sectional study included Thai patients were diagnosed with axSpA by a rheumatologist at Siriraj Hospital. Clinical data were collected. Regression analyses were employed to identify factors associated with study outcomes. Of total 177 patients, 127 (72%) were positive HLA-B27. Uveitis [Odds ratio (OR) 4.0], age at onset of the first musculoskeletal symptom of ≤ 28 years [OR 3.5], female [OR 0.4], and psoriasis [OR 0.4] were significantly associated with HLA-B27 in multiple regression analysis. Those with positive HLA-B27 had less spinal flexibility. Elevated C-reactive protein (p = 0.012) was associated with shorter delay in diagnosis, while uveitis (p < 0.001) and younger age at onset of the first symptom (p = 0.002) were associated with longer delay in diagnosis in multiple regression analysis. Younger age at onset of the first musculoskeletal symptom and uveitis were associated with HLA-B27 and delayed diagnosis in axSpA patients. Young people with musculoskeletal symptom and uveitis should be referred to a rheumatologist to rule out or make a timely diagnosis of axSpA.

scholarly journals Educational aspects of rare and orphan lung diseases

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Tiago M. Alfaro ◽  
Marlies S. Wijsenbeek ◽  
Pippa Powell ◽  
Daiana Stolz ◽  
John R. Hurst ◽  
...  
Keyword(s):  
Lung Diseases ◽  
Healthcare Professionals ◽  
Treatment Options ◽  
Delayed Diagnosis ◽  
Reference Network ◽  
Delay In Diagnosis ◽  
Positive Effects ◽  
European Reference Network ◽  
Patient Representatives ◽  
Rare Lung Diseases

AbstractPeople with rare lung diseases often suffer the burden of delayed diagnosis, limited treatment options, and difficulties in finding expert physicians. One of the reasons for the delay in diagnosis is the limited training for healthcare practitioners on rare diseases. This review explores the main concerns and needs for education on rare lung diseases from the perspectives of both patients and professionals. Despite the increasing interest in rare lung disorders and some recent breakthrough developments on the management of several diseases, healthcare professionals, including general practitioners and hospital workers, receive little education on this topic. Nonetheless, many healthcare professionals show much interest in receiving further training, especially on diagnosis. Patients and families want easier access to high-quality education materials to help them manage their own disease. Well-educated patients are better equipped to deal with chronic diseases, but patient education can be challenging as patients’ individual health issues, and diverse backgrounds can create significant barriers. Raising more awareness for rare lung diseases and further development of patient-centred international expert networks like the European Reference Network on Rare Lung Diseases (ERN-LUNG), which includes both experts and patient representatives, are essential for improving care and education on rare lung diseases. Initiatives such as the Rare Disease Day, have been successful in increasing awareness for rare conditions. The development of online tools for accessing information has had positive effects and should be further supported and extended in the future.

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