Korean J Thorac Cardiovasc Surg.  2003 Jan;36(1):51-54.

Iatrogenic Large Esophageal perforation caused by Sengstaken-Blackmore Tube

• Yoon YC
• Cho KH
• Kwon YM
• Jun HJ
• Choi KJ
• Lee YH
• Hwang YH

Abstract

This patient was an 53-year-old man who had undergone Sengstaken-Blackmore tube insertion for esophageal varix bleeding. Two days after Sengstaken-Blackmore tube insertion, he developed severe left hemothorax and was transferred to our hospital. The esophagoscopic findings revealed a large perforation lengthening 8-cm in the intrathoracic esophagus. A left thoracotomy was performed 33 days after the injury due to repeated varix bleedings and poor conditions. An 8-cm longitudinal perforation of the intrathoracic esophagus with gross suppurative empyema was found. Primary repair and esophageal exclusion was performed 2cm proximal and distal to the perforation, using rows of nonabsorbable staplers (TA stapler 60x4.8) and large bore thoracostomy tubes were placed for local drainage. Six days after intrathoracic esophageal exclusion, an esophagogram revealed a leakage at just above the proximal stapling site. A cervical esophageal exclusion was performed using the same method. One hundred thirty seven days after exclusion operation for the intra-thoracic esophageal perforation, the patient was able to eat per orally without any secondary esophageal reconstructive surgery.

Keyword

Esophageal perfroation; Iatrogenic disease; Balloon

MeSH Terms

Drainage
Empyema
Esophageal and Gastric Varices
Esophageal Perforation*
Esophagus
Hemorrhage
Hemothorax
Humans
Iatrogenic Disease
Middle Aged
Thoracostomy
Thoracotomy
Varicose Veins