• Korean Journal of Bronchoesophagology
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• v.10 no.2
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• pp.55-57
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• 2004

We report a case of successful transesophageal drainge of thoracic esophageal perforation with mediastinal cavities using two 5Fr angiographic pigtail catheters with portable suction bag(Hemovac)

• Journal of Chest Surgery
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• v.21 no.1
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• pp.169-174
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• 1988

Thoracic esophageal rupture caused by blunt trauma is often not recognized until late because of the vague symptoms in the initial state as well as its rare incidence, which can easily lead to fulminant mediastinitis with frequent fatal outcome. Once extensive mediastinitis occurs, the primary surgical repair of the esophageal tear is considered to be practically impossible. Various methods have been proposed for the management of these desperately ill patients, but no one provides an acceptable good result yet. The purpose of this article is to report the successful result obtained in the treatment of a patient with fulminant mediastinitis from traumatic esophageal rupture by continuous transesophageal irrigation. A 27 year-old male patient was brought to the emergency room of our hospital complaining of dyspnea and chest pain after blunt trauma. The diagnosis of esophageal rupture in the thorax was made late, about 46 hours after the initial injury, when mediastinitis had already progressed. The transesophageal irrigation method was immediately instituted which consisted of profuse transesophageal irrigation of the mediastinum with orally ingested fluid and/or by Levin tube, positioned proximal to the site of the rupture, and drainage of the irrigation fluid by thoracoscopically accurately positioned chest tubes connected to a well suctioning system. With subsiding inflammatory signs and symptoms, the esophagogram, obtained 54 days after the treatment, showed no evidence of the mediastinal leakage of contrast material which contrasted previous esophagograms with definitive dye collections in the mediastinum. Additional endoscopic finding confirmed complete healing of the esophageal mucosa, previously ruptured. He has been followed up without any problem until recently, 6 months after discharge.

• Clinical Endoscopy
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• v.57 no.4
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• pp.527-533
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• 2024

Background/Aims: Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (EUS-HGS) performed at the intrahepatic bile duct segment 3 (B3) is widely used for biliary drainage. Although performing post-puncture procedures is easier in the intrahepatic bile duct segment 2 (B2) when using a conventional oblique-viewing (OV) EUS scope, this method may cause transesophageal puncture and severe adverse events. We evaluated the safety and efficacy of B2 puncture using a novel OV-EUS scope. Methods: In this single-center retrospective study, we prospectively enrolled and collected data from 45 patients who consecutively underwent EUS-HGS procedures with a novel OV-EUS scope between September 2021 and December 2022 at our cancer center. Results: The technical success rates of B2-EUS-HGS and EUS-HGS were 93.3% (42/45) and 97.8% (44/45), respectively. The early adverse event rate was 8.9% (4/45) with no cases of scope changes or transesophageal punctures. The median procedure time was 13 minutes (range, 5-30). Conclusions: B2-EUS-HGS can be performed safely with the novel EG-740UT (Fujifilm) OV-scope without transesophageal puncture and with a high success rate. B2-EUS-HGS using this novel OV scope may be the preferred strategy for EUS-HGS.

• Journal of Chest Surgery
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• v.37 no.12
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• pp.999-1002
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• 2004

Thirteen year old boy who had been stabbed in his left chest by the knife was transferred to our department from a general hospital, because of the massive bleeding from the intercostal tube drainage. Chest X-ray showed homogeneous density in the left lung field. He was confused and his vital signs were unstable. He was moved into a operating room as soon as possible. After resuscitation, his lacerated left ventricle wound was sutured through median sternotomy. The interventricular shunt was detected with intraoperative transesophageal echocardiography. The traumatic ventricular septal defect was closed via left ventricle using Dacron patch. His postoperative course was uneventful, and he was discharged with small residual shunt.