Esophageal rupture: a severe complication of transesophageal echocardiography

Ano: 2012 | Volume: 2 | Número: 3

Autores: F. P. F. Campos, B. M. R. Martines, J. A. S. Martines, J. A. B. Araújo Filho

Palavras-chave: echocardiography transesophageal, mediastinitis, esophagus, iatrogenic disease.

Resumo Inglês:

Since when the first transesophageal echocardiography (TEE) was undertaken
in 1975, technological advances have made this diagnostic modality more
reliable. TEE indications became widespread in cardiac and non-cardiac
surgeries, intensive care units, and ambulatory clinics. The procedure is
generally considered a safe diagnostic tool, but occasionally complications
do occur. The insertion and manipulation of the ultrasound probe can
cause oropharyngeal, esophageal, or gastric trauma. Although rare, these
complications may present a mortality rate of up to 56% depending on the
treatment approach and the elapsed time to the diagnosis. The authors report
a case of a 65-year-old woman submitted to attempt a TEE in order to better
study or diagnose an inter-atrial communication. After 3 days of the procedure,
the patient was admitted to the hospital with edema, hyperemia of the anterior
face of the neck, accompanied by systemic symptoms. The imaging diagnostic
work-up evidenced signs of esophageal rupture and upper mediastinal
involvement, the former confirmed by upper gastrointestinal endoscopy. The
patient was treated with antibiotics and cervical and mediastinal drainage,
with a favorable outcome.