Download PDF
CC BY 4.0 · European J Pediatr Surg Rep. 2022; 10(01): e131-e134
DOI: 10.1055/s-0042-1756207
Case Report

Esophageal Perforation into the Pericardium in a 3-Year-Old Child with Esophageal Stricture: A Rare Complication Following Esophageal Dilatation

Abdulrahman Nasser
1   College of Medicine, Taibah University, Al Madinah Al Monawrrah, Saudi Arabia
,
Raif Nassir
2   Department of Pediatric Surgery, King Salman Medical City, Al Madinah Al Monawrrah, Saudi Arabia
,
Muhammad Younas Awan
3   Department of Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
,
Mohammad Anas AlShawa
3   Department of Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
,
Zakaria Habib
3   Department of Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Perforation of the esophagus during dilatation is a rare complication that might cause mortality. We present the report of a 3-year-old girl who was diagnosed with B cell acute lymphoblastic leukemia at 17 months of age. She experienced a complicated clinical course after chemotherapy was initiated, which included mucositis and acute pericarditis. She later developed an acquired esophageal stricture and tracheoesophageal fistula, which were managed with resection and primary anastomosis when she was in remission. Postoperatively, the patient developed a leak, which was treated conservatively. She subsequently developed a stricture that was treated successfully. On the fourth dilatation attempt and after she was sent home, she presented with persistent vomiting and low-grade fever and became vitally unstable on the same day, after stabilization, upper gastroenterology contrast revealed contrast filling the pericardium. She was managed conservatively with close observation and serial echocardiograms and then discharged home on day 18 in good condition after complete resolution of the pericardial effusion.

Keywords

esophageal dilatation - pneumomediastinum - pericardial perforation


Publication History

Received: 10 July 2021

Accepted: 19 May 2022

Article published online:
02 September 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Rentea RM, Peter SDS. Neonatal and pediatric esophageal perforation. Seminars Pediatr Surg 2017; 26 (02) 87-94
    CrossrefPubMedGoogle Scholar
  • 2 Panieri E, Millar AJ, Rode H, Brown RA, Cywes S. Iatrogenic esophageal perforation in children: patterns of injury, presentation, management, and outcome. J Pediatr Surg 1996; 31 (07) 890-895
    CrossrefPubMedGoogle Scholar
  • 3 Lal DR, Foroutan HR, Su WT, Wolden SL, Boulad F, La Quaglia MP. The management of treatment-related esophageal complications in children and adolescents with cancer. J Pediatr Surg 2006; 41 (03) 495-499
    CrossrefPubMedGoogle Scholar
  • 4 Mohamed AM. Clinical characteristics of pediatric patients with esophageal strictures. Pediatric 2020; 42 (04) 261-265
    PubMedGoogle Scholar
  • 5 Chiang C-M, Hsu W-M, Chang M-H. et al. Risk factors and management for anastomotic stricture after surgical reconstruction of esophageal atresia. J Formos Med Assoc 2021; 120 (1 Pt 2): 404-410
    CrossrefPubMedGoogle Scholar
  • 6 Rintala RJ, Pakarinen MP. Long-term outcome of esophageal anastomosis. Eur J Pediatr Surg 2013; 23 (03) 219-225
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Serhal L, Gottrand F, Sfeir R. et al. Anastomotic stricture after surgical repair of esophageal atresia: frequency, risk factors, and efficacy of esophageal bougie dilatations. J Pediatr Surg 2010; 45 (07) 1459-1462
    CrossrefPubMedGoogle Scholar
  • 8 Zhao R, Li K, Shen C, Zheng S. The outcome of conservative treatment for anastomotic leakage after surgical repair of esophageal atresia. J Pediatr Surg 2011; 46 (12) 2274-2278
    CrossrefPubMedGoogle Scholar
  • 9 Huet F, Mougenot JF, Saleh T, Vannerom Y. Esophageal dilatation in pediatrics: study of 33 patients [in French]. Arch Pediatr 1995; 2 (05) 423-430
    PubMedGoogle Scholar
  • 10 Campos J, Tan Tanny SP, Kuyruk S. et al. The burden of esophageal dilatations following repair of esophageal atresia. J Pediatr Surg 2020; 55 (11) 2329-2334
    CrossrefPubMedGoogle Scholar
  • 11 Poddar U, Thapa BRJGE. Benign esophageal strictures in infants and children: results of Savary-Gilliard bougie dilation in 107 Indian children. Gastrointest Endosc 2001; 54 (04) 480-484
    CrossrefPubMedGoogle Scholar
  • 12 Govindarajan KKJKJOP. Esophageal perforation in children: etiology and management, with special reference to endoscopic esophageal perforation. Korean J Pediatr 2018; 61 (06) 175-179
    CrossrefPubMedGoogle Scholar
  • 13 El-Asmar KM, Elghandour MM, Allam AMJJOPS. Iatrogenic esophageal perforation caused by endoscopic dilatation of caustic stricture: current management and possibility of esophageal salvage. J Pediatr Surg 2021; 56 (04) 692-696
    CrossrefPubMedGoogle Scholar
  • 14 Mignosa C, Agati S, Gitto P, Salvo D, Trimarchi ES. Cardiac tamponade: rare presentation of acquired pericardial-esophageal fistula. J Thorac Cardiovasc Surg 2005; 130 (06) 1711-1712
    CrossrefPubMedGoogle Scholar