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Updated: Mar 19, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Perforation of the hypopharynx after transesophageal echocardiography
Takayuki Onishi1, Yuko Onishi2, Keiko Tachibana2
1Department of Cardiology, Hiratsuka Kyosai Hospital, 9-11 Oiwake, Hiratsuka, Japan. ohnishi-t@kkr.hiratsuka.kanagawa.jp.
Abstract:
A 65-year-old obese woman with an oversized neck and dysphagia underwent transesophageal echocardiography (TEE). The procedure was complicated by difficulty in insertion from the pharynx to esophagus, and her head and neck gradually swelled. Computed tomography (CT) revealed extensive emphysema from the neck to superior mediastinum, which suggested pharyngeal perforation. A nasogastric tube was inserted, and the patient received antibiotics to prevent secondary mediastinitis. CT performed 1 week later showed improvement of emphysema and no evidence of mediastinitis. Perforation along the orogastric pathway during TEE is a rare but life-threatening complication to which physicians performing TEE should pay attention.
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