Korean J Thorac Cardiovasc Surg.  2017 Oct;50(5):395-398. 10.5090/kjtcs.2017.50.5.395.

Internal Drainage of an Esophageal Perforation in a Patient with a High Surgical Risk

• Kim H
• Kim Y
• Cho JH
• Min YW

• KMID: 2398398
• DOI: http://doi.org/10.5090/kjtcs.2017.50.5.395

Abstract

A 71-year-old man presented with a productive cough and fever, and he was diagnosed as having an esophageal perforation and a mediastinal abscess. He had a history of traumatic hemothorax and pleural drainage for empyema in the right chest and was considered unable to tolerate thoracic surgery because of sepsis and progressive aspiration pneumonia. In order to aggressively drain the mediastinal contamination, we performed internal drainage by placing a Levin tube into the mediastinum through the perforation site. This procedure, in conjunction with controlling sepsis and providing sufficient postpyloric nutrition, allowed the esophageal injury to completely heal.

Keyword

Esophageal perforation; Mediastinitis

MeSH Terms

Abscess
Aged
Cough
Drainage*
Empyema
Esophageal Perforation*
Fever
Hemothorax
Humans
Mediastinitis
Mediastinum
Pneumonia, Aspiration
Sepsis
Thoracic Surgery
Thorax