Esophagopleural fistula after endoscopic sclerotherapy in a child

Abstract

Endoscopic sclerotherapy (EST) for variceal hemorrhage is a reasonably safe procedure. Minor complications such as fever, chest pain, dysphagia, pleural effusion, and esophageal ulceration are common. Major complications (e.g., perforation) occur in only 1% to 4% of cases. 1 Schuman BM Beckman JW Tedesco FJ Griffin JW Assad RT. Complications of endoscopic injection sclerotherapy: a review. Am J Gastroenterol. 1987; 82: 823-830 PubMed Google Scholar Esophageal perforation may occur early due to injury produced with the endoscope or may be delayed due to wall necrosis induced by the sclerosant. 1 Schuman BM Beckman JW Tedesco FJ Griffin JW Assad RT. Complications of endoscopic injection sclerotherapy: a review. Am J Gastroenterol. 1987; 82: 823-830 PubMed Google Scholar In the era of fiberoptic endoscopy, perforation due to instrumentation is unusual, but a few cases of delayed perforation have been reported in adults. 2 Bacon BR Camara DS Duffy MC. Severe ulceration and delayed perforation of the esophagus after endoscopic variceal sclerotherapy. Gastrointest Endosc. 1987; 33: 311-315 Abstract Full Text PDF PubMed Scopus (20) Google Scholar , 3 Korula J Pandya K Yamada S. Perforation of esophagus after endoscopic variceal sclerotherapy. Dig Dis Sci. 1989; 34: 324-329 Crossref PubMed Scopus (23) Google Scholar , 4 Shemesh E Bat L. Esophageal perforation after fiberoptic endoscopic injection sclerotherapy for esophageal varices. Arch Surg. 1980; 121: 243-245 Crossref Scopus (23) Google Scholar , 5 Soderlund C Wiechel K-L. Oesophageal perforation after sclerotherapy for variceal haemorrhage. Acta Chir Scand. 1983; 149: 491-495 PubMed Google Scholar