Related Experiment Video
Updated: May 30, 2026
10:52
Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Intramural dissection with mucosal rupture alleviating phlegmonous esophagitis
Po-Chih Chang1, Wen-Lun Wang, Tzer-Zen Hwang
1Division of Thoracic Surgery, Department of Surgery, E-DA Hospital/I-Shou University, Kaohsiung City, Taiwan. dyno910076@hotmail.com
Summary
A rare complication of nasogastric tube insertion, esophageal intramural dissection, unexpectedly resolved a severe deep neck infection and acute phlegmonous esophagitis in a patient who fully recovered with antibiotics and endoscopic repair.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Surgical Complications
Background:
- Deep neck infections and acute phlegmonous esophagitis present with severe odynophagia and chest pain.
- Nasogastric tube (NGT) insertion is a common procedure for nutritional support and gastric decompression.
Observation:
- A patient developed esophageal intramural dissection with mucosal rupture following routine NGT insertion.
- This complication led to the vomiting of pus, suggesting a link to the underlying infection.
Findings:
- The patient was treated with antibiotics and delayed endoscopic closure of the esophageal rupture.
- Esophageal intramural dissection, though a rare complication, appeared to paradoxically alleviate the acute phlegmonous esophagitis.
Implications:
- This case highlights a potential, albeit unusual, mechanism by which esophageal injury might decompress or resolve severe esophageal infections.
- Clinicians should be aware of rare esophageal complications associated with NGT insertion, even in the context of severe infection.
- Further investigation into the pathogenesis of NGT-associated esophageal intramural dissection is warranted.
Related Concept Videos
01:28Esophageal Perforation-II: Clinical Manifestations and Management
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
01:22Esophageal Perforation-I: Introduction
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
01:19Appendicitis
Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
01:27Esophageal Achalasia
Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide (VIP)...
01:27Peptic Ulcer
Peptic ulcers are erosive lesions of the gastric or duodenal lining, most commonly caused by Helicobacter pylori infection. This Gram-negative, helical bacterium has adapted to survive the stomach’s acidic environment by producing urease, which converts urea into ammonia and carbon dioxide. The ammonia neutralizes gastric acid in the bacterium’s immediate environment, allowing colonization of the gastric mucosa. H. pylori attaches to mucus-secreting epithelial cells, penetrates the mucus...