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http://dx.doi.org/10.4250/jcu.2015.23.3.181

A RARE CASE OF IATROGENIC DEEP NECK INFECTION SECONDARY TO HYPOPHARYNGEAL INJURY CAUSED BY THE TRANSESOPHAGEAL ECHOCARDIOGRAPHY  

Kim, Hyung Yoon (Division of Cardiology, Department of Medicine, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Lee, Sang-Chol (Division of Cardiology, Department of Medicine, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Park, Sung-Ji (Division of Cardiology, Department of Medicine, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Choi, Jin-Oh (Division of Cardiology, Department of Medicine, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Chang, Sung-A (Division of Cardiology, Department of Medicine, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Kim, Sung Mok (Department of Radiology, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Choe, Yeon Hyeon (Department of Radiology, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Oh, Jae K. (Division of Cardiology, Department of Medicine, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Park, Seung Woo (Division of Cardiology, Department of Medicine, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Publication Information
Journal of Cardiovascular Imaging / v.23, no.3, 2015 , pp. 181-185 More about this Journal
Abstract
Transesophageal echocardiography (TEE) is considered relatively safe but semi-invasive. The hypopharyngeal and esophageal injury is infrequent complication of TEE but could be serious, even life-threatening. We present a case of a 74-year-old man who experienced a deep neck infection secondary to hypopharyngeal injury following TEE. The diagnosis was made because of the subcutaneous emphysema developed 3 hours after TEE. In spite of antibiotics therapy with prolonged fasting, a right parapharyngeal and retropharyngeal abscess was developed 5 days later. With ultrasound-guided drainage of abscess and continuous antibiotic treatment, infection was controlled. The patent underwent mitral valve repair after 14 days of antibiotic therapy. The patient recovered uneventfully. For cardiologists performing TEE, it is required to know complications and their risk factors to minimize hypopharyngeal and esophageal injury.
Keywords
Hypopharyngeal injury; Transesophageal echocardiography; Complications; Hypopharynx; Iatrogenic deep neck infection;
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