Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-26T20:16:01.583Z Has data issue: false hasContentIssue false
  • English
  • Français

Perforation after rigid pharyngo-oesophagoscopy: when do symptoms and signs develop?

Published online by Cambridge University Press:  20 October 2009

M Daniel ,
T Kamani ,
C Nogueira ,
M-C Jaberoo ,
P Conboy ,
M Johnston  and
P Bradley
M Daniel*
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Nottingham, UK
T Kamani
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Derbyshire Hospitals, Derby, UK
C Nogueira
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Derbyshire Hospitals, Derby, UK
M-C Jaberoo
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, St Bartholomew's Hospital, London, UK
P Conboy
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, University Hospitals Leicester, UK
M Johnston
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Derbyshire Hospitals, Derby, UK
P Bradley
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Nottingham, UK
*
Address for correspondence: Mr Mat Daniel, Otorhinolaryngology Head and Neck Surgery, University Hospital Nottingham, Derby Road, Nottingham NG7 2UH, UK. Fax: 0115 970 9748 E-mail: mat.daniel@nuh.nhs.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Perforation after pharyngo-oesophagoscopy is a serious complication, and its identification, through close patient monitoring, is essential. Yet little is known about when symptoms and signs develop, and thus how long any close monitoring should last.

Aim:

To examine the timing of individual symptoms and signs of perforation after rigid pharyngo-oesophagoscopy.

Methodology:

Three-centre, retrospective study.

Results:

Of 3459 patients undergoing rigid pharyngo-oesophagoscopy, 10 (0.29 per cent) developed perforations, nine of which were suspected intra-operatively. Symptoms and signs developed at 1.5 hours post-operatively at the earliest, and at 36 hours at the latest. Three patients were asymptomatic. The majority of procedures (n = 8) were undertaken for food bolus obstruction or foreign body ingestion.

Conclusion:

Pharyngo-oesophagoscopy for food bolus obstruction and foreign body ingestion accounts for a large number of perforations, but symptoms and signs may take longer than 24 hours to develop. A contrast swallow should be considered in high risk patients, and a high index of suspicion maintained in order to detect this complication.

Keywords

OesophagoscopyOesophageal PerforationComplications
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 2 , February 2010 , pp. 171 - 174
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented as a poster at the British Academic Conference in Otolaryngology, 8–10 July 2009, Liverpool.

References

1Michel, L, Grillo, HC, Malt, RA. Operative and nonoperative management of esophageal perforations. Ann Surg 1981;194:57–63CrossRefGoogle ScholarPubMed
2Han, SY, McElvein, RB, Aldrete, JS, Tishler, JM. Perforation of the esophagus: correlation of site and cause with plain film findings. AJR Am J Roentgenol 1985;145:537–40CrossRefGoogle ScholarPubMed
3Braghetto, I, Rodríguez, A, Csendes, A, Korn, O. An update on esophageal perforation [in Spanish]. Rev Med Chil 2005;133:1233–41Google Scholar
4Kubba, H, Spinou, E, Brown, D. Is same-day discharge suitable following rigid esophagoscopy? Findings in a series of 655 cases. Ear Nose Throat J 2003;82:33–6CrossRefGoogle Scholar
5Zwischenberger, JB, Savage, C, Bidani, A. Surgical aspects of esophageal disease: perforation and caustic injury. Am J Respir Crit Care Med 2002;165:1037–40CrossRefGoogle ScholarPubMed
6Buecker, A, Wein, BB, Neuerburg, JM, Guenther, RW. Esophageal perforation: comparison of use of aqueous and barium-containing contrast media. Radiology 1997;202:683–6CrossRefGoogle ScholarPubMed
7Huber-Lang, M, Henne-Bruns, D, Schmitz, B, Wuerl, P. Esophageal perforation: principles of diagnosis and surgical management. Surg Today 2006;36:332–40Google Scholar
8Commission on the Provision of Surgical Services. Guidelines for Day Case Surgery, 2nd edn.London: Royal College of Surgeons of England, 1992Google Scholar
9Galloway, JM, Gibson, J, Dalrymple, J. Endoscopy in primary care – a survey of current practice. Br J Gen Pract 2002;52:536–8Google ScholarPubMed