Acute Mediastinitis Following Esophageal Perforation with Swallowing of Duck Bone: A Case Report

Tran Thuc Khang

doi:doi:10.11648/j.ijcts.20210706.13

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Acute Mediastinitis Following Esophageal Perforation with Swallowing of Duck Bone: A Case Report

Tran Thuc Khang

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 7, Issue 6)

Received: 29 October 2021 Accepted: 15 November 2021 Published: 23 November 2021

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Abstract

Background: Acute mediastinitis is still associated with a high morbidity and mortality. Mediastinitis secondary to esophageal perforation is a rare but potentially life-threatening condition. Case presentation: This report aims to present an acute mediastinitis case, in a 54-year-old healthy female patient, which originated from an intrathoracic esophageal perforation with swallowing of duck bone that confirmed by computed tomography of the chest. The patient was successfully treated by an emergency left thoracotomy, effective surgical drainage and aggressive debridement of the affected mediastinal compartments, primitive repair of perforated esophagus with intercostal muscle flap, decompressive gastrostomy and jejunostomy for feeding. Post-operatively, the patient was benefited from broad-spectrum antibiotics, intensive care and resuscitation associated with a close follow-up consequence. Results: Mediastinitis was well-controlled. Post interventional computed tomography scan with hydro-soluble contrast ingestion showed no extraluminal leak and good integrity of esophagus. The patient restored normally oral feeding without any complications and was discharged after 24 days of hospitalization without any sequelae. Conclusions: Early diagnosis is critical for expediting the choice of an optimal treatment strategy and plays an important role in improving mortality from acute mediastinitis following perforated esophagus. Besides intensive care and resuscitation, we advocate an emergency thoracic surgery for cases with established mediastinitis following intrathoracic esophageal perforation.

Published in	International Journal of Cardiovascular and Thoracic Surgery (Volume 7, Issue 6)
DOI	10.11648/j.ijcts.20210706.13
Page(s)	70-74
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Mediastinitis, Esophageal Perforation, Debridement, Surgical Drainage, Intercostal Muscle Flap

References

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APA Style

Tran Thuc Khang. (2021). Acute Mediastinitis Following Esophageal Perforation with Swallowing of Duck Bone: A Case Report. International Journal of Cardiovascular and Thoracic Surgery, 7(6), 70-74. https://doi.org/10.11648/j.ijcts.20210706.13

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ACS Style

Tran Thuc Khang. Acute Mediastinitis Following Esophageal Perforation with Swallowing of Duck Bone: A Case Report. Int. J. Cardiovasc. Thorac. Surg. 2021, 7(6), 70-74. doi: 10.11648/j.ijcts.20210706.13

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AMA Style

Tran Thuc Khang. Acute Mediastinitis Following Esophageal Perforation with Swallowing of Duck Bone: A Case Report. Int J Cardiovasc Thorac Surg. 2021;7(6):70-74. doi: 10.11648/j.ijcts.20210706.13

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@article{10.11648/j.ijcts.20210706.13,
  author = {Tran Thuc Khang},
  title = {Acute Mediastinitis Following Esophageal Perforation with Swallowing of Duck Bone: A Case Report},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {7},
  number = {6},
  pages = {70-74},
  doi = {10.11648/j.ijcts.20210706.13},
  url = {https://doi.org/10.11648/j.ijcts.20210706.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20210706.13},
  abstract = {Background: Acute mediastinitis is still associated with a high morbidity and mortality. Mediastinitis secondary to esophageal perforation is a rare but potentially life-threatening condition. Case presentation: This report aims to present an acute mediastinitis case, in a 54-year-old healthy female patient, which originated from an intrathoracic esophageal perforation with swallowing of duck bone that confirmed by computed tomography of the chest. The patient was successfully treated by an emergency left thoracotomy, effective surgical drainage and aggressive debridement of the affected mediastinal compartments, primitive repair of perforated esophagus with intercostal muscle flap, decompressive gastrostomy and jejunostomy for feeding. Post-operatively, the patient was benefited from broad-spectrum antibiotics, intensive care and resuscitation associated with a close follow-up consequence. Results: Mediastinitis was well-controlled. Post interventional computed tomography scan with hydro-soluble contrast ingestion showed no extraluminal leak and good integrity of esophagus. The patient restored normally oral feeding without any complications and was discharged after 24 days of hospitalization without any sequelae. Conclusions: Early diagnosis is critical for expediting the choice of an optimal treatment strategy and plays an important role in improving mortality from acute mediastinitis following perforated esophagus. Besides intensive care and resuscitation, we advocate an emergency thoracic surgery for cases with established mediastinitis following intrathoracic esophageal perforation.},
 year = {2021}
}

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TY  - JOUR
T1  - Acute Mediastinitis Following Esophageal Perforation with Swallowing of Duck Bone: A Case Report
AU  - Tran Thuc Khang
Y1  - 2021/11/23
PY  - 2021
N1  - https://doi.org/10.11648/j.ijcts.20210706.13
DO  - 10.11648/j.ijcts.20210706.13
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 70
EP  - 74
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20210706.13
AB  - Background: Acute mediastinitis is still associated with a high morbidity and mortality. Mediastinitis secondary to esophageal perforation is a rare but potentially life-threatening condition. Case presentation: This report aims to present an acute mediastinitis case, in a 54-year-old healthy female patient, which originated from an intrathoracic esophageal perforation with swallowing of duck bone that confirmed by computed tomography of the chest. The patient was successfully treated by an emergency left thoracotomy, effective surgical drainage and aggressive debridement of the affected mediastinal compartments, primitive repair of perforated esophagus with intercostal muscle flap, decompressive gastrostomy and jejunostomy for feeding. Post-operatively, the patient was benefited from broad-spectrum antibiotics, intensive care and resuscitation associated with a close follow-up consequence. Results: Mediastinitis was well-controlled. Post interventional computed tomography scan with hydro-soluble contrast ingestion showed no extraluminal leak and good integrity of esophagus. The patient restored normally oral feeding without any complications and was discharged after 24 days of hospitalization without any sequelae. Conclusions: Early diagnosis is critical for expediting the choice of an optimal treatment strategy and plays an important role in improving mortality from acute mediastinitis following perforated esophagus. Besides intensive care and resuscitation, we advocate an emergency thoracic surgery for cases with established mediastinitis following intrathoracic esophageal perforation.
VL  - 7
IS  - 6
ER  -

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Author Information

Tran Thuc Khang

Department of Cardiovascular and Thoracic Surgery, XUYEN A Hospital, Hochiminh City, Vietnam

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Plain Text BibTeX RIS

APA Style

Tran Thuc Khang. (2021). Acute Mediastinitis Following Esophageal Perforation with Swallowing of Duck Bone: A Case Report. International Journal of Cardiovascular and Thoracic Surgery, 7(6), 70-74. https://doi.org/10.11648/j.ijcts.20210706.13

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ACS Style

Tran Thuc Khang. Acute Mediastinitis Following Esophageal Perforation with Swallowing of Duck Bone: A Case Report. Int. J. Cardiovasc. Thorac. Surg. 2021, 7(6), 70-74. doi: 10.11648/j.ijcts.20210706.13

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AMA Style

Tran Thuc Khang. Acute Mediastinitis Following Esophageal Perforation with Swallowing of Duck Bone: A Case Report. Int J Cardiovasc Thorac Surg. 2021;7(6):70-74. doi: 10.11648/j.ijcts.20210706.13

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@article{10.11648/j.ijcts.20210706.13,
  author = {Tran Thuc Khang},
  title = {Acute Mediastinitis Following Esophageal Perforation with Swallowing of Duck Bone: A Case Report},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {7},
  number = {6},
  pages = {70-74},
  doi = {10.11648/j.ijcts.20210706.13},
  url = {https://doi.org/10.11648/j.ijcts.20210706.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20210706.13},
  abstract = {Background: Acute mediastinitis is still associated with a high morbidity and mortality. Mediastinitis secondary to esophageal perforation is a rare but potentially life-threatening condition. Case presentation: This report aims to present an acute mediastinitis case, in a 54-year-old healthy female patient, which originated from an intrathoracic esophageal perforation with swallowing of duck bone that confirmed by computed tomography of the chest. The patient was successfully treated by an emergency left thoracotomy, effective surgical drainage and aggressive debridement of the affected mediastinal compartments, primitive repair of perforated esophagus with intercostal muscle flap, decompressive gastrostomy and jejunostomy for feeding. Post-operatively, the patient was benefited from broad-spectrum antibiotics, intensive care and resuscitation associated with a close follow-up consequence. Results: Mediastinitis was well-controlled. Post interventional computed tomography scan with hydro-soluble contrast ingestion showed no extraluminal leak and good integrity of esophagus. The patient restored normally oral feeding without any complications and was discharged after 24 days of hospitalization without any sequelae. Conclusions: Early diagnosis is critical for expediting the choice of an optimal treatment strategy and plays an important role in improving mortality from acute mediastinitis following perforated esophagus. Besides intensive care and resuscitation, we advocate an emergency thoracic surgery for cases with established mediastinitis following intrathoracic esophageal perforation.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Acute Mediastinitis Following Esophageal Perforation with Swallowing of Duck Bone: A Case Report
AU  - Tran Thuc Khang
Y1  - 2021/11/23
PY  - 2021
N1  - https://doi.org/10.11648/j.ijcts.20210706.13
DO  - 10.11648/j.ijcts.20210706.13
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 70
EP  - 74
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20210706.13
AB  - Background: Acute mediastinitis is still associated with a high morbidity and mortality. Mediastinitis secondary to esophageal perforation is a rare but potentially life-threatening condition. Case presentation: This report aims to present an acute mediastinitis case, in a 54-year-old healthy female patient, which originated from an intrathoracic esophageal perforation with swallowing of duck bone that confirmed by computed tomography of the chest. The patient was successfully treated by an emergency left thoracotomy, effective surgical drainage and aggressive debridement of the affected mediastinal compartments, primitive repair of perforated esophagus with intercostal muscle flap, decompressive gastrostomy and jejunostomy for feeding. Post-operatively, the patient was benefited from broad-spectrum antibiotics, intensive care and resuscitation associated with a close follow-up consequence. Results: Mediastinitis was well-controlled. Post interventional computed tomography scan with hydro-soluble contrast ingestion showed no extraluminal leak and good integrity of esophagus. The patient restored normally oral feeding without any complications and was discharged after 24 days of hospitalization without any sequelae. Conclusions: Early diagnosis is critical for expediting the choice of an optimal treatment strategy and plays an important role in improving mortality from acute mediastinitis following perforated esophagus. Besides intensive care and resuscitation, we advocate an emergency thoracic surgery for cases with established mediastinitis following intrathoracic esophageal perforation.
VL  - 7
IS  - 6
ER  -

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