Missed Iatrogenic Cervical Esophageal Injury: A Favorable Result in a Late Case

Main Article Content

Misauq Mazcuri
Ambreen Abid
Tanveer Ahmad
Nazish Sikander
Pratikshya Thapaliya

Abstract

Missed iatrogenic cervical esophageal injury after thyroidectomy is a rare complication. Post-operative painful deglutition, subcutaneous emphysema or local swelling should raise the alarm. Seven days after thyroidectomy, a patient was referred to us with copious purulent discharge and saliva draining from cervical wound. Cervical incision was taken down; wound irrigated and kept open for dressings. Focused wound management along with enteral feeding via feeding jejunostomy was initiated. Esophagoscopy was done in the second week and proximal edge of defect was identified. During the third week, when wound was clean and patient had gained her lost weight back, mucosal and muscular layers were repaired with interposition flap between esophagus and trachea. On seventh post-repair day esophagogram was normal. Patient was discharged on semisolids. Six weeks postoperatively, endoscopy and dilation was done for grade II dysphagia. Six months later, patient remains symptom free.

Keywords:
Cervical esophageal perforation, iatrogenic, thyroidectomy, mortality

Article Details

How to Cite
Mazcuri, M., Abid, A., Ahmad, T., Sikander, N., & Thapaliya, P. (2020). Missed Iatrogenic Cervical Esophageal Injury: A Favorable Result in a Late Case. Asian Journal of Case Reports in Surgery, 5(2), 12-16. Retrieved from https://www.journalajcrs.com/index.php/AJCRS/article/view/30160
Section
Case Report

References

Vázquez-Rodríguez J, Pelet del Toro N, García-Rodríguez O, et al. Traumatic esophageal perforation in Puerto Rico Trauma Hospital: A case-series. Annals of Medicine and Surgery. 2019;44:62-67.

DOI: 10.1016/j.amsu.2019.06.01

Aghajanzadeh M, Porkar N, Ebrahimi H. Cervical esophageal perforation: A 10-year clinical experience in North of Iran. Indian Journal of Otolaryngology and Head & Neck Surgery. 2014;67(S1):34-39.

DOI: 10.1007/s12070-014-0737-z

Maupoey Ibáñez J, Ballester Pla, N, García-Domínguez R, Vaqué Urbaneja J, Mingol Navarro F .Surgical Management of a Complete Section of the Oesophagus During Total Thyroidectomy. Cirugía Española (English Edition). 2017;95(2): 118-120. 10.1016/j.cireng.2017.03.004

Chirica M, Kelly M, Siboni S, Aiolfi A, Riva C, Asti E, et al. Esophageal emergencies: WSES guidelines. World Journal of Emergency Surgery. 2019;14(1).

DOI: 10.1186/s13017-019-0245-2

Abila A, Nditika M, Kipkemoi R, Ondigo S, Khwa-Otsyula B. Primary repair of esophageal perforation: Case report. International Journal of Surgery Case Reports. 2020;71:159-162.

DOI: 10.1016/j.ijscr.2020.04.026

Park A, Yoo Y, Choi J, Chung E. Usefulness of vacuum-assisted closure therapy in the treatment of esophageal perforation following thyroidectomy. Korean Journal of Otorhinolaryngology-Head and Neck Surgery. 2017;60(5):252-256.

DOI: 10.3342/kjorl-hns.2016.17342

Ward N, Lee C, Lee J, Sloan D. Esophageal fistula complicating thyroid lobectomy. Journal of Surgical Case Reports. 2015;2015(1):rju136-rju136.

DOI: 10.1093/jscr/rju136

Yu C, Chien C, Hsieh P, Chien R. Cervical esophageal perforation during endoscopic ultrasonography: A retrospective evaluation of frequency, outcome, and patient management. Advances in Digestive Medicine. 2018; 5(3):93-97.

DOI: 10.1002/aid2.13085

Eroğlu A. Minimally invasive management of esophageal perforation. The Turkish Journal of Thoracic and Cardiovascular Surgery. 2018;26(3):496-503.

DOI: 10.5606/tgkdc.dergisi.2018.15354

Sudarshan M, Cassivi S. Management of traumatic esophageal injuries. Journal of Thoracic Disease. 2019;11(S2):S172-S176.

DOI: 10.21037/jtd.2018.10.86

Mavroudis C, Kucharczuk J. Acute management of esophageal perforation. Current Surgery Reports. 2013;2(1).

DOI: 10.1007/s40137-013-0034-x

Lambert R, Angmorterh S, Benjamin M, Gonzalez M, Aboagye S, Ofori E. Esophageal perforation by tilapia fish bone ingestion – A case report. International Journal of Surgery Case Reports. 2020;71: 23-26.

DOI: 10.1016/j.ijscr.2020.04.054

Mammadov E, Alim A, Eliçevik M, Celayir S. Traumatic upper cervical esophageal perforation in childhood with door handle. Annals of Pediatric Surgery. 2011;7(1):25-26.

DOI:10.1097/01.xps.0000393088.31815.6d.

Puertavicente A, JimÉNez P., López M, Nisa F, Velasco G, Álvarez, J et al. Management of Esophageal Perforation: 28-Year Experience in a Major Referral Center. The American Surgeon. 2018; 84(5):684-689.

DOI: 10.1177/000313481808400520