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Perforation after rigid pharyngo-oesophagoscopy: when do symptoms and signs develop?
M Daniel1, T Kamani, C Nogueira
1Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Nottingham, UK. mat.daniel@nuh.nhs.uk
The Journal of Laryngology and Otology
|October 21, 2009
Summary
Perforation after pharyngo-oesophagoscopy can have delayed symptoms, developing up to 36 hours post-procedure. Early suspicion and monitoring are crucial for timely diagnosis of this serious complication.
Area of Science:
- Gastroenterology
- Surgical Complications
- Diagnostic Imaging
Background:
- Pharyngo-oesophagoscopy carries a risk of perforation, a serious complication requiring prompt identification.
- Current knowledge regarding the onset of symptoms and signs post-perforation is limited, impacting monitoring duration.
Purpose of the Study:
- To investigate the temporal patterns of individual symptoms and signs following rigid pharyngo-oesophagoscopy.
Main Methods:
- A retrospective study was conducted across three medical centers.
- Data from 3459 patients undergoing rigid pharyngo-oesophagoscopy were analyzed.
Main Results:
- Ten patients (0.29%) experienced perforations, with nine suspected intra-operatively.
- Symptom and sign onset ranged from 1.5 to 36 hours post-procedure; three patients remained asymptomatic.
- Most perforations occurred during procedures for food bolus obstruction or foreign body ingestion.
Conclusions:
- Pharyngo-oesophagoscopy for food bolus or foreign body ingestion is associated with a significant number of perforations.
- Symptoms may manifest beyond 24 hours, necessitating a high index of suspicion.
- Consideration of contrast swallow in high-risk patients is recommended for early detection.
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