Int J Gastrointest Interv.  2019 Jan;8(1):59-61. 10.18528/ijgii190004.

Iatrogenic pyriform sinus perforation during endoscopic ultrasonography

• Kim YM
• Park JJ
• Youn YH

• KMID: 2437973
• DOI: http://doi.org/10.18528/ijgii190004

Abstract

SUMMARY OF EVENT: A 65-year-old women underwent endoscopic ultrasonography (EUS) to evaluate the gastric submucosal tumor. The EUS scope was inserted into the esophagus after two attempts. A neck computed tomography (CT) scan showed a pneumomediastinum and an air bubble deep in the neck, suggesting an esophageal rupture. The patient was hospitalized and maintained conservative treatment including broad-spectrum antibiotics and withholding oral feeding. TEACHING POINT: Endoscopists should consider an imaging modality when a patient complains of moderate to severe neck pain after an upper endoscopy. Prompt surgical management should be considered in patients with a delayed diagnosis (> 24 hours), those with signs of systemic toxicity, and those who have eaten between the time of the procedure and when the perforation was detected.

Keyword

Endoscopic ultrasonography; Iatrogenic perforation; Pyriform sinus

MeSH Terms

Aged
Anti-Bacterial Agents
Delayed Diagnosis
Endoscopy
Endosonography*
Esophagus
Female
Humans
Mediastinal Emphysema
Neck
Neck Pain
Pyriform Sinus*
Rupture
Anti-Bacterial Agents