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Cuando la rutina se vuelve rara: hematemesis masiva que revela una perforación hipofaríngea causada por un drenaje de

A D Asimakopoulos¹, C Arquero Dominguez², A Avagnina³

¹Department of Otorhinolaryngology - Head and Neck Surgery, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland; Department of Otorhinolaryngology - Head and Neck Surgery, Saint-Étienne University Hospital, Saint-Étienne, France; Jacques-Lisfranc School of Medicine, University Jean-Monnet, Saint-Étienne, France.

European annals of otorhinolaryngology, head and neck diseases

|February 21, 2026

Resumen

Se trató con éxito una rara perforación hipofaríngea después de una discectomía cervical anterior, que presentaba una hematemesis masiva. Este caso pone de relieve la importancia de una colocación cuidadosa del drenaje y la vigilancia postoperatoria para prevenir complicaciones aerodigestivas graves.

Área de la Ciencia:

La medicina es la medicina de la medicina.
Cirugía La cirugía es la cirugía.
La otorrinolaringología otorrinolaringología.

Sus antecedentes:

La perforación hipofaríngea es una complicación rara y potencialmente mortal de los procedimientos cervicales / aerodigestivos.
Los síntomas sutiles y la ubicación profunda dificultan el reconocimiento temprano, aumentando los riesgos de mediastinitis y sepsis.
La hematemesis masiva como síntoma inicial es excepcionalmente poco común y difícil de diagnosticar.

Objetivo del estudio:

Para informar de un raro caso de perforación hipofaríngea iatrogénica.
Para resaltar la presentación atípica y los desafíos de diagnóstico.
Hacer hincapié en las medidas preventivas para las complicaciones aerodigestivas.

Principales métodos:

Un hombre de 49 años de edad se sometió a una discectomía cervical anterior (C4-C5).
Después de la extubación, se presentó con una hematemesis masiva.
La endoscopia reveló una perforación de seno piriforme por un drenaje de Redon; se realizó una reparación endoscópica con suturas y sellador de fibrina.

Principales resultados:

La perforación hipofaríngea se cerró con éxito endoscópicamente.
El paciente experimentó un curso postoperatorio sin incidentes.
Se observó una recuperación completa sin estenosis o fístula a los tres meses de seguimiento.

Conclusiones:

La perforación hipofaríngea iatrogénica puede ocurrir después de una discectomía cervical anterior, presentándose atípicamente con hematemesis masiva.
La colocación meticulosa del drenaje y la vigilancia postoperatoria son cruciales para prevenir las complicaciones aerodigestivas.
El reconocimiento temprano y la pronta intervención endoscópica son claves para un manejo exitoso.

Palabras clave:

Se realizó una discectomía cervical anterior.La reparación endoscópica es una reparación endoscópica.Perforación de la hipofaringe.Hay una hematemesis masiva.Redon drenaje de succión de drenaje.

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