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Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
Published on: August 22, 2025
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Esophageal Perforation Successfully Treated With EVT.
Kavea Panneerselvam1, Ronald Samuel2, Robert J Sealock2
1Baylor College of Medicine, Department of Medicine, Houston, Texas.
ACG Case Reports Journal
|January 17, 2022
Summary
Esophageal perforation, though rare, is serious. A dental floss pick caused a fistula between the esophagus and vena cava, successfully treated with endoluminal vacuum therapy.
Area of Science:
- Gastroenterology
- Surgical Innovation
Background:
- Esophageal perforation presents a significant clinical challenge due to high morbidity and mortality rates.
- Prompt diagnosis and intervention are critical for favorable patient outcomes.
Observation:
- A 54-year-old male patient exhibited fever and confusion.
- Imaging demonstrated air within the hepatic inferior vena cava, suggesting a potential fistula between the distal esophagus and the vena cava.
Findings:
- Upper endoscopic examination identified a dental floss pick perforating the distal esophagus.
- Successful removal of the foreign body was achieved.
- Endoluminal vacuum therapy was employed to facilitate closure of the esophageal perforation.
Implications:
- This case highlights the importance of considering unusual foreign bodies in the differential diagnosis of esophageal perforation.
- Endoluminal vacuum therapy represents a promising, minimally invasive approach for managing full-thickness gastrointestinal defects.
- The successful resolution underscores the potential of novel endoscopic techniques in treating complex esophageal injuries.
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