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General Critical Care

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A 47-year-old man with past medical history significant for tobacco use, prior alcohol use, presumed COPD, and recent evaluation for a possible esophageal mass status post EGD on 7/22 with findings of stenosis and circumferential ulceration involving the distal esophagus status post dilation and biopsy.

Patient was admitted on 7/29 for acute hypoxic respiratory failure, ARDS, and septic shock with findings of left-sided pleural effusion and pneumothorax confirmed to be esophageal perforation. S/P chest tubes, EGD, and stenting.

Left sided pneumothorax

CT of the chest confirming extravasation of water-soluble contrast from the left lateral wall of the esophagus at the level of the GE junction.


The area of extravasation distal esophigus

Extravasation of contrast at GE junction
Extravasation of contrast at GE junction

EGD conformed a medium-sized perforation at the gastroesophageal junction. This defect


Perforation at GE junction
Perforation at GE junction

This was stented with an 18 mm x 10.3 cm WallFlex covered stent. Clip placed to secure stent.


Dr.Yasser Alwali
dr.nawaf
Noor Ali Shah
nahlanoureldaimnou

Esophageal stent is clearly seen on the CXR

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