Huh Jung, Yang Jinsun, Kang Seung Joo, Kang Hyoun Woo, Moon Hyeon Jong, Kim Su Hwan, Kim Bokyung, Kim Ji Won, Lee Kook Lae, Seong Yong Won, Kim Kwang Woo
Division of Gastroenterology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
Korean J Helicobacter Up Gastrointest Res. 2024 Jun;24(2):187-192. doi: 10.7704/kjhugr.2024.0025. Epub 2024 Jun 10.
Esophageal perforation can lead to serious complications, and rapid diagnosis and treatment significantly affect the prognosis. Endoscopic vacuum-assisted closure (EndoVAC) therapy is widely accepted as a safe, well-tolerated, effective, versatile and practical procedure for the management of esophageal perforation in selected patients. We report the successful use of EndoVAC therapy for management of an esophageal perforation secondary to foreign body removal. A 56-year-old man presented to the emergency department for evaluation of chest pain after swallowing the plastic shell of a pill. Emergency endoscopy revealed an esophageal wall laceration (approximately 3 cm) and microperforation. The esophageal laceration and microperforation were limited to the mid-esophagus. The patient underwent EndoVAC therapy, which was repeated every 3-4 days for a total of six sessions over a period of 21 days. We observed improvement in the esophageal injury with granulation tissue formation during the fifth session. Subsequent follow-up evaluation, including esophagography and chest computed tomography confirmed complete healing of the esophageal injury. Following resumption of diet, the patienton a was discharged without any complications.
食管穿孔可导致严重并发症，快速诊断和治疗对预后有显著影响。内镜下真空辅助闭合（EndoVAC）治疗被广泛认为是一种安全、耐受性良好、有效、多功能且实用的方法，用于治疗特定患者的食管穿孔。我们报告了成功使用EndoVAC治疗因异物取出继发的食管穿孔。一名56岁男性因吞咽药丸塑料壳后胸痛到急诊科就诊。急诊内镜检查发现食管壁撕裂（约3厘米）和微小穿孔。食管撕裂和微小穿孔局限于食管中段。患者接受了EndoVAC治疗，每3 - 4天重复一次，在21天内共进行了6次治疗。在第5次治疗期间，我们观察到食管损伤有改善，并有肉芽组织形成。随后的随访评估，包括食管造影和胸部计算机断层扫描证实食管损伤完全愈合。恢复饮食后，患者无任何并发症出院。
