Esophageal perforation associated with the esophageal obturator airway

The esophageal obturator airway (EOA) has been approved since 1973 as an adjunct for artificial ventilation. Description of the tube and contraindications to its use are presented. The two primary complications are tracheal intubation and esophageal perforation. A case report of esophageal perforation after EOA use is presented and a brief review of the previously reported cases is correlated with this case report. The true incidence of this complication has never been accurately studied but estimates vary between 0 and 2%. Possible factors contributing to this complication are discussed and recommendations regarding proper inflation are given. Because early diagnosis and treatment is essential, helpful historical, clinical, and radiographic findings that are presented should help to increase the index of suspicion of this complication. Increased familiarity with the EOA by physicians in the emergency department and the ICU is also necessary for early diagnosis and treatment.