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Traumatic and Nontraumatic Esophageal Emergency

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Emergency Chest Radiology

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Abstract

Esophageal injury is a rare but potentially life-threatening condition. Endoscopic or surgical procedures are the most common causes of esophageal perforation which may lead to mediastinitis. Esophageal emergencies may initially present nonspecific clinical manifestations but characteristic imaging features which are crucial for ensuring an accurate diagnosis. In this chapter, the pathophysiology and characteristic imaging findings of traumatic and non-traumatic esophageal emergencies including esophageal perforation, Boerhaave’s syndrome, esophageal intramural dissection, esophageal hernia, acute phlegmonous esophagitis, and aortoesophageal fistula are discussed.

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References

  1. Costamagna G, Marchese M. Management of esophageal perforation after therapeutic endoscopy. Gastroenterol Hepatol (N Y). 2010;6(6):391–2.

    Google Scholar 

  2. Quine MA, Bell GD, McCloy RF, Matthews HR. Prospective audit of perforation rates following upper gastrointestinal endoscopy in two regions of England. Br J Surg. 1995;82(4):530–3. https://doi.org/10.1002/bjs.1800820430.

    Article  CAS  PubMed  Google Scholar 

  3. Ren JF, Lin D, Marchlinski FE, Callans DJ, Patel V. Esophageal imaging and strategies for avoiding injury during left atrial ablation for atrial fibrillation. Heart Rhythm. 2006;3(10):1156–61. https://doi.org/10.1016/j.hrthm.2006.06.006.

    Article  PubMed  Google Scholar 

  4. Brinster CJ, Singhal S, Lee L, Marshall MB, Kaiser LR, Kucharczuk JC. Evolving options in the management of esophageal perforation. Ann Thorac Surg. 2004;77(4):1475–83. https://doi.org/10.1016/j.athoracsur.2003.08.037.

    Article  PubMed  Google Scholar 

  5. Sudarshan M, Cassivi SD. Management of traumatic esophageal injuries. J Thorac Dis. 2019;11(Suppl 2):S172–6. https://doi.org/10.21037/jtd.2018.10.86.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Teh E, Edwards J, Duffy J, Beggs D. Boerhaave’s syndrome: a review of management and outcome. Interact Cardiovasc Thorac Surg. 2007;6(5):640–3. https://doi.org/10.1510/icvts.2007.151936.

    Article  PubMed  Google Scholar 

  7. James AE Jr, Montali RJ, Chaffee V, Strecker EP, Vessal K. Barium or gastrografin: which contrast media for diagnosis of esophageal tears? Gastroenterology. 1975;68(5 Pt 1):1103–13.

    Article  Google Scholar 

  8. Buecker A, Wein BB, Neuerburg JM, Guenther RW. Esophageal perforation: comparison of use of aqueous and barium-containing contrast media. Radiology. 1997;202(3):683–6. https://doi.org/10.1148/radiology.202.3.9051016.

    Article  CAS  PubMed  Google Scholar 

  9. Tonolini M, Bianco R. Spontaneous esophageal perforation (Boerhaave syndrome): diagnosis with CT-esophagography. J Emerg Trauma Shock. 2013;6(1):58–60. https://doi.org/10.4103/0974-2700.106329.

    Article  PubMed  PubMed Central  Google Scholar 

  10. de Lutio di Castelguidone E, Merola S, Pinto A, Raissaki M, Gagliardi N, Romano L. Esophageal injuries: spectrum of multidetector row CT findings. Eur J Radiol. 2006;59(3):344–8. https://doi.org/10.1016/j.ejrad.2006.04.027.

    Article  PubMed  Google Scholar 

  11. Backer CL, LoCicero J 3rd, Hartz RS, Donaldson JS, Shields T. Computed tomography in patients with esophageal perforation. Chest. 1990;98(5):1078–80. https://doi.org/10.1378/chest.98.5.1078.

    Article  CAS  PubMed  Google Scholar 

  12. Ghanem N, Altehoefer C, Springer O, et al. Radiological findings in Boerhaave’s syndrome. Emerg Radiol. 2003;10(1):8–13. https://doi.org/10.1007/s10140-002-0264-1.

    Article  PubMed  Google Scholar 

  13. Restrepo CS, Lemos DF, Ocazionez D, Moncada R, Gimenez CR. Intramural hematoma of the esophagus: a pictorial essay. Emerg Radiol. 2008;15(1):13–22. https://doi.org/10.1007/s10140-007-0675-0.

    Article  PubMed  Google Scholar 

  14. Younes Z, Johnson DA. The spectrum of spontaneous and iatrogenic esophageal injury: perforations, Mallory-Weiss tears, and hematomas. J Clin Gastroenterol. 1999;29(4):306–17. https://doi.org/10.1097/00004836-199912000-00003.

    Article  CAS  PubMed  Google Scholar 

  15. Cullen SN, McIntyre AS. Dissecting intramural haematoma of the oesophagus. Eur J Gastroenterol Hepatol. 2000;12(10):1151–62. https://doi.org/10.1097/00042737-200012100-00014.

    Article  CAS  PubMed  Google Scholar 

  16. Stilson WL, Sanders I, Gardiner GA, Gorman HC, Lodge DF. Hiatal hernia and gastroesophageal reflux. A clinicoradiological analysis of more than 1,000 cases. Radiology. 1969;93(6):1323–7.

    Article  CAS  Google Scholar 

  17. Kahrilas PJ, Kim HC, Pandolfino JE. Approaches to the diagnosis and grading of hiatal hernia. Best Pract Res Clin Gastroenterol. 2008;22(4):601–16. https://doi.org/10.1016/j.bpg.2007.12.007.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Kohn GP, Price RR, DeMeester SR, et al. Guidelines for the management of hiatal hernia. Surg Endosc. 2013;27(12):4409–28. https://doi.org/10.1007/s00464-013-3173-3.

    Article  PubMed  Google Scholar 

  19. Morcos SK. Review article: Effects of radiographic contrast media on the lung. Br J Radiol. 2003;76(905):290–5. https://doi.org/10.1259/bjr/54892465.

    Article  CAS  PubMed  Google Scholar 

  20. Eren S, Ciris F. Diaphragmatic hernia: diagnostic approaches with review of the literature. Eur J Radiol. 2005;54(3):448–59. https://doi.org/10.1016/j.ejrad.2004.09.008.

    Article  PubMed  Google Scholar 

  21. Al-Balas H, Hani MB, Omari HZ. Radiological features of acute gastric volvulus in adult patients. Clin Imaging. 2010;34(5):344–7. https://doi.org/10.1016/j.clinimag.2010.02.001.

    Article  PubMed  Google Scholar 

  22. Hsu CY, Liu JS, Chen DF, Shih CC. Acute diffuse phlegmonous esophagogastritis: report of a survived case. Hepatogastroenterology. 1996;43(11):1347–52.

    CAS  PubMed  Google Scholar 

  23. Kim HS, Hwang JH, Hong SS, et al. Acute diffuse phlegmonous esophagogastritis: a case report. J Korean Med Sci. 2010;25(10):1532–5. https://doi.org/10.3346/jkms.2010.25.10.1532.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Yun CH, Cheng SM, Sheu CI, Huang JK. Acute phlegmonous esophagitis: an unusual case (2005: 8b). Eur Radiol. 2005;15(11):2380–1. https://doi.org/10.1007/s00330-005-2842-6.

    Article  PubMed  Google Scholar 

  25. Kim GY, Ward J, Henessey B, et al. Phlegmonous gastritis: case report and review. Gastrointest Endosc. 2005;61(1):168–74. https://doi.org/10.1016/s0016-5107(04)02217-5.

    Article  PubMed  Google Scholar 

  26. Isik A, Firat D, Peker K, Sayar I, Idiz O, Soyturk M. A case report of esophageal perforation: complication of nasogastric tube placement. Am J Case Rep. 2014;15:168–71. https://doi.org/10.12659/AJCR.890260.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Wakayama T, Watanabe H, Ishizaki Y, et al. A case of phlegmonous esophagitis associated with diffuse phlegmonous gastritis. Am J Gastroenterol. 1994;89(5):804–6.

    CAS  PubMed  Google Scholar 

  28. Shin HS, Kim SS, Kim JH. Acute phlegmonous esophagitis with mediastinitis complicated by an esophageal perforation: a case report. J Korean Soc Radiol. 2018;79(1):45–9.

    Article  Google Scholar 

  29. Heckstall RL, Hollander JE. Aortoesophageal fistula: recognition and diagnosis in the emergency department. Ann Emerg Med. 1998;32(4):502–5. https://doi.org/10.1016/s0196-0644(98)70182-9.

    Article  CAS  PubMed  Google Scholar 

  30. Hollander JE, Quick G. Aortoesophageal fistula: a comprehensive review of the literature. Am J Med. 1991;91(3):279–87. https://doi.org/10.1016/0002-9343(91)90129-l.

    Article  CAS  PubMed  Google Scholar 

  31. Carter R, Mulder GA, Snyder EN Jr, Brewer LA III. Aortoesophageal fistula. Am J Surg. 1978;136(1):26–30. https://doi.org/10.1016/0002-9610(78)90195-2.

    Article  CAS  PubMed  Google Scholar 

  32. Sipe A, McWilliams SR, Saling L, Raptis C, Mellnick V, Bhalla S. The red connection: a review of aortic and arterial fistulae with an emphasis on CT findings. Emerg Radiol. 2017;24(1):73–80. https://doi.org/10.1007/s10140-016-1433-y.

    Article  PubMed  Google Scholar 

  33. Halvorsen RA Jr, Thompson WM. Computed tomographic staging of gastrointestinal tract malignancies. Part I. Esophagus and stomach. Invest Radiol. 1987;22(1):2–16.

    Article  Google Scholar 

  34. Young CA, Menias CO, Bhalla S, Prasad SR. CT features of esophageal emergencies. Radiographics. 2008;28(6):1541–53. https://doi.org/10.1148/rg.286085520.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (Republic of)

    Tae Jung Kim, Yeon Hyeon Choe & Kyung Soo Lee

  2. Department of Radiology, Seoul National University Bundang Hospital, Kyonggi-do, Korea (Republic of)

    Kyung Hee Lee

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Kim, T.J., Lee, K.H., Choe, Y.H., Lee, K.S. (2021). Traumatic and Nontraumatic Esophageal Emergency. In: Emergency Chest Radiology. Springer, Singapore. https://doi.org/10.1007/978-981-33-4396-2_5

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  • DOI: https://doi.org/10.1007/978-981-33-4396-2_5

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