Related Experiment Video
Updated: Aug 31, 2026

Robotic Heller Myotomy for Advancements in Surgical Management of Achalasia
Published on: February 16, 2024
Esophageal Perforation During Dilation in a Patient With Hypopharyngeal Metastatic Squamous Cell Carcinoma
David Ai1, Mauna I Rao1, Ashley C Wetzig1
1Department of Anesthesiology, Baylor College of Medicine, Houston, USA.
Abstract:
We report the case of a 75-year-old female with a history of stage IVa hypopharyngeal squamous cell carcinoma who presented with dysphagia due to cervical esophageal stricture after prior laryngopharyngectomy and cervical esophagectomy. During rigid pharyngeal dilation, an acute and uncontained cervical esophageal perforation involving the superior mediastinum occurred, leading to pneumomediastinum. This was immediately complicated by her surgically altered anatomy creating bilateral pneumothoraces, tension pneumoperitoneum, and subsequent hemodynamic instability. Prompt recognition and emergent intervention, including needle decompression, chest tube placement, exploratory laparotomy, and intensive postoperative care, stabilized the patient's condition. This case highlights the challenges in managing high-risk patients with complex airway and esophageal conditions, underscoring the importance of multidisciplinary coordination and rapid response in preventing fatal outcomes.
Related Concept Videos
Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
Esophageal Perforation-I: Introduction
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
Esophageal Achalasia
Esophageal Strictures-I: Introduction
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Hiatal Hernia