Conservative management of a case of transesophageal echocardiogram-induced esophageal perforation

Abstract

Esophageal injury or perforation is a rare but life threatening complication of transesophageal echocardiography (TEE). Most of the patients manifest symptoms within 24 hours of the procedure and upper esophagus is the most common site of injury. Incidence of esophageal perforation is relatively rare, in a large series of 10,000 cases of TEE, the incidence of esophageal perforation was reported in 3 cases (0.03%) and in another study it was found to be 1 in 5,000 TEEs, 0.02%. This is a case report that highlights a case of esophageal perforation and false passage discovered accidentally 24 hours postoperatively, in contrast to most of the previous esophageal perforation case reports, a conservative management was undertaken successfully since the discovery of the complication until the full recovery and the discharge of the patient from the cardiac ICU, a follow up upper gastrointestinal endoscopy and CT chest showed progressive resolution of the hematoma surrounding the esophagus, healing of the false passage and recovery of the mediastinal gas locules.