Tadayon Seyed Mohammad Kazem, Moeinvaziri Nader, Amini Masoud, Setoodeh Maryam, Haghighat Neda
Laparoscopy Research Center, Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Laparoscopy Research Center, Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Int J Surg Case Rep. 2021 Apr;81:105793. doi: 10.1016/j.ijscr.2021.105793. Epub 2021 Mar 19.
Esophageal perforation (EF) is an uncommon complication of bariatric procedures, mostly related to the intraoperative use of bougie that is used for gastric calibration.
Here, we present a 33-year-old woman who underwent laparoscopy sleeve surgery (LSG). Due to perforation in the cervical site of the esophagus caused by bougie insertion, she developed subcutaneous emphysema on the first post-operative day. She immediately underwent reconstructive esophageal surgery under the probable diagnosis of having a cervical esophagus perforation. The patient's condition was stable in the postoperative period and discharged after 10 days.
The patients who present symptoms including subcutaneous emphysema, cervical pain, dysphagia, dysphonia, and fever post-surgery have to be considered for probably EF. The early optimal diagnosis works up and therapeutic approach should be performed as soon as possible to prevent mortality.
EP caused by a bougie insertion is an uncommon complication that is associated with high mortality rates if the diagnosis and treatment were delayed. The risk of using a bougie during surgery should not be underestimated and have to be inserted with extreme caution and careful guide of surgeon.
食管穿孔（EF）是减肥手术中一种不常见的并发症，主要与术中用于胃校准的探条使用有关。
在此，我们报告一名33岁接受腹腔镜袖状胃切除术（LSG）的女性。由于探条插入导致食管颈部穿孔，她在术后第一天出现皮下气肿。在可能诊断为颈段食管穿孔的情况下，她立即接受了食管重建手术。患者术后病情稳定，10天后出院。
术后出现皮下气肿、颈部疼痛、吞咽困难、声音嘶哑和发热等症状的患者，必须考虑可能发生了食管穿孔。应尽早进行最佳的早期诊断检查和治疗，以预防死亡。
探条插入引起的食管穿孔是一种不常见的并发症，如果诊断和治疗延迟，死亡率很高。手术中使用探条的风险不可低估，必须在外科医生的谨慎指导下极其小心地插入。
