DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20211587

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

Jalal Almarzooq, Ayman Alkhabbaz, Nabeel Abdulla

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.


Keywords


Esophageal perforation, Esophageal fistula, Foreign body ingestion

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References


Selivanov V, Sheldon GF, Cello JP, Crass RA. Management of foreign body ingestion. Ann Surg. 1984;199(2):187-91.

Venkatesh SH, Venkatanarasimha Karaddi NK. CT findings of accidental fish bone ingestion and its complications. Diagn Interv Radiol. 2016;22(2):156-60.

Kim HU. Oroesophageal fish bone foreign body. Clin Endosc. 2016;49(4):318-26.

Toma EA, Oun M, Enciu O, Calu V, Miron A. The surgical management of acute esophageal perforation by accidentally ingested fish bone. Chirurgia (Bucur). 2018;113(1):156-61.

Kim JP, Kwon OJ, Shim HS, Kim RB, Kim JH, Woo SH. Analysis of clinical feature and management of fish bone ingestion of upper gastrointestinal tract. Clin Exp Otorhinolaryngol. 2015;8(3):261-7.

Bathla G, Teo LL, Dhanda S. Pictorial essay: complications of a swallowed fish bone. Indian J Radiol Imaging. 2011;21(1):63-8.

Kaman L, Iqbal J, Kundil B, Kochhar R. Management of Esophageal Perforation in Adults. Gastroenterology Res. 2010;3(6):235-44.

Chirica M, Kelly MD, Siboni S, Aiolfi A, Riva GC, Asti E, et al. Esophageal emergencies: WSES guidelines. World J Emerg Surg. 2019;14:26.

Altorjay A, Kiss J, Vörös A, Bohák A. Nonoperative management of esophageal perforations. Is it justified? Ann Surg. 1997;225(4):415-21.