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Esophageal perforation during attempted endotracheal intubation
The Journal of Thoracic and Cardiovascular Surgery
|July 1, 1979
Summary
Esophageal perforation during tracheal intubation is rare but serious. Early diagnosis and surgical intervention lead to prompt recovery, while delayed treatment significantly increases mortality risk.
Area of Science:
- Medicine
- Surgery
- Gastroenterology
Background:
- Tracheal intubation is a common procedure, but rare complications like cervical esophageal perforation can occur.
- Esophageal perforation during intubation is an underreported iatrogenic injury.
Observation:
- A 11-year study identified 12 patients (age 44-72) treated for cervical esophageal perforation post-intubation.
- Symptoms include dysphagia, neck pain, and early subcutaneous cervical emphysema, especially after difficult intubation.
Findings:
- Early surgical repair (within 12 hours) resulted in uneventful and prompt recovery for all patients.
- Delayed surgical treatment (over 12 hours) or nonoperative management led to a 56% mortality rate and prolonged, difficult recovery.
Implications:
- Prompt diagnosis and surgical intervention are critical for improving outcomes in esophageal perforation after intubation.
- Timely management can prevent severe morbidity and mortality associated with this rare complication.