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. 2019 Mar 15;5(1):21.
doi: 10.1186/s40981-019-0243-0.

A case of esophageal perforation after intraoperative transesophageal echocardiography in a patient with a giant left atrium: unexpectedly large distortion of the esophagus revealed on retrospectively constructed three-dimensional imaging

Aya Kimura  1 , Takashi Mori  2 , Yuki Kihara  2 , Chie Watanabe  2 , Katsuaki Tanaka  2 , Tokuhiro Yamada  2 , Atushi Yoshida  3 , Joji Kawabe  3 , Yoshito Sakon  4 , Toshihiko Sibata  4 , Kiyonobu Nishikawa  2
Affiliations

A case of esophageal perforation after intraoperative transesophageal echocardiography in a patient with a giant left atrium: unexpectedly large distortion of the esophagus revealed on retrospectively constructed three-dimensional imaging

Aya Kimura et al. JA Clin Rep. .

Abstract

Background: Esophageal perforation is a rare but serious complication of transesophageal echocardiography (TEE). An enlarged left atrium (LA), which is commonly associated with mitral stenosis (MS), is an under-recognized risk factor for esophageal perforation after intraoperative TEE.

Case presentation: We describe a case of TEE-induced esophageal perforation after cardiac surgery in a 79-year-old woman with a giant LA due to MS. Esophageal perforation was detected on postoperative day 6. After surgical repair, the patient gradually recovered with prolonged conservative treatment. Retrospectively constructed three-dimensional chest computed tomography images revealed an unusually distorted esophagus that was possibly vulnerable to injury.

Conclusion: A giant LA can markedly distort the esophagus. It should be recognized as a risk factor for TEE-induced esophageal perforation.

Keywords: Esophageal perforation; Giant left atrium; Mitral stenosis; Transesophageal echocardiography.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Chest radiography just after the cardiac surgery. The course and the tip position of the NG tube were unusually shifted to the right
Fig. 2
Fig. 2
Three-dimensional images of the esophagus. a Anterior view. b Posterior view. c Right lateral oblique view. d Left lateral oblique view. The course of the esophagus is shown in red. The esophagus was compressed and distorted by the enlarged left atrium
See this image and copyright information in PMC

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