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Zhu RY, Law TT, Tong D, Tam G, Law S. Spontaneous circumferential intramural esophageal dissection complicated with esophageal perforation and esophageal-pleural fistula: a case report and literature review. Dis Esophagus 2016; 29:872-879. [PMID: 24602017 DOI: 10.1111/dote.12200] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Spontaneous intramural esophageal dissection (IED) is a rare disease entity. There are few reports of spontaneous IED requiring surgical treatment. Hereby, we report a 37-year-old gentleman who was diagnosed to have spontaneous extensive circumferential IED complicated with esophageal perforation, empyema, and esophageal-pleural fistula. Esophageal stenting and drainage of empyema were unsuccessful. Computed tomography and gastrografin contrast swallow demonstrated a leak to the pleural cavity, suggestive of esophageal-pleural fistula. Subsequently, a two-stage operation was performed: cervical esophagogastrostomy to bypass the perforated esophagus, followed by esophagectomy and decortication of the right lung. The patient recovered and was discharged home after a 3-week hospitalization. The management principles and recent published literature related to IED were reviewed.
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Affiliation(s)
- R Y Zhu
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - T T Law
- Division of Esophageal and Upper Gastrointestinal Surgery, Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - D Tong
- Division of Esophageal and Upper Gastrointestinal Surgery, Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - G Tam
- Division of Esophageal and Upper Gastrointestinal Surgery, Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - S Law
- Division of Esophageal and Upper Gastrointestinal Surgery, Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong.
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McGhie JS, de Groot-de Laat L, Ren B, Vletter W, Frowijn R, Oei F, Geleijnse ML. Transthoracic two-dimensional xPlane and three-dimensional echocardiographic analysis of the site of mitral valve prolapse. Int J Cardiovasc Imaging 2015; 31:1553-60. [PMID: 26276508 PMCID: PMC4651983 DOI: 10.1007/s10554-015-0734-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 08/03/2015] [Indexed: 02/07/2023]
Abstract
This study sought to assess the value of two-dimensional (2D) transthoracic echocardiography (TTE), 2D xPlane imaging and three-dimensional (3D) TTE for the definition of the site and the extent of mitral valve (MV) prolapse. Fifty patients underwent transthoracic 2D, 2D xPlane and 3D echocardiography. With 2D xPlane a segmental analysis of the MV was performed, by making a lateral sweep across the MV coaptation line as seen in the parasternal short-axis view. Inter-observer agreement for specific scallop prolapse was for 2D xPlane excellent (97 %, kappa = 0.94) and for 3D TTE moderate (85 %, kappa = 0.67). The respective sensitivities of standard 2D TTE, 2D xPlane, and 3D TTE for the identification of the precise posterior scallop prolapse were for P1 92, 85, and 92 %, for P2 96, 96, and 82 %, and for P3 86, 81, and 71 %. In total, 5 (8 %) prolapsing MV scallops were missed by 2D TTE, 7 (12 %) by 2D xPlane, and 12 (20 %) by 3D TTE. The sensitivity of 3D TTE was significantly lower than standard 2D imaging (80 % versus 93 %, P < 0.05). The extent of P2 prolapse was under or overestimated in 5 patients with 2D xPlane and in 9 patients with 3D TTE. 2D xPlane imaging is an accurate, easy to use (compared to 3D TTE) and easy to interpret (compared to 2D and 3D TTE) imaging modality to study the site and the extent of MV prolapse.
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Affiliation(s)
- Jackie S McGhie
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
| | - Lotte de Groot-de Laat
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Ben Ren
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Wim Vletter
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - René Frowijn
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Frans Oei
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Marcel L Geleijnse
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
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KUMAR SAURABH, BROWN GREGOR, SUTHERLAND FIONA, MORGAN JOHN, ANDREWS DAVID, LING LIANGHAN, McLELLAN ALEXJ, LEE GEOFFREY, ROBINSON TIMOTHY, HECK PATRICK, HALLORAN KAREN, MORTON JOSEPH, KISTLER PETER, KALMAN JONATHANM, SPARKS PAULB. The Transesophageal Echo Probe May Contribute to Esophageal Injury After Catheter Ablation for Paroxysmal Atrial Fibrillation Under General Anesthesia: A Preliminary Observation. J Cardiovasc Electrophysiol 2014; 26:119-26. [DOI: 10.1111/jce.12575] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 10/05/2014] [Accepted: 10/14/2014] [Indexed: 12/18/2022]
Affiliation(s)
- SAURABH KUMAR
- Department of Cardiology; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
- Department of Medicine; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
| | - GREGOR BROWN
- Alfred Hospital and Baker IDI; Prahran Victoria Australia
| | - FIONA SUTHERLAND
- Department of Cardiology; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
| | - JOHN MORGAN
- Department of Cardiology; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
| | - DAVID ANDREWS
- Department of Cardiology; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
- Department of Medicine; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
| | - LIANG-HAN LING
- Department of Cardiology; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
- Alfred Hospital and Baker IDI; Prahran Victoria Australia
| | - ALEX J.A. McLELLAN
- Department of Cardiology; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
- Alfred Hospital and Baker IDI; Prahran Victoria Australia
| | - GEOFFREY LEE
- Department of Cardiology; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
- Department of Medicine; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
| | - TIMOTHY ROBINSON
- Department of Cardiology; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
| | - PATRICK HECK
- Department of Cardiology; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
| | - KAREN HALLORAN
- Department of Cardiology; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
| | - JOSEPH MORTON
- Department of Cardiology; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
- Department of Medicine; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
| | - PETER KISTLER
- Department of Cardiology; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
- Alfred Hospital and Baker IDI; Prahran Victoria Australia
| | - JONATHAN M. KALMAN
- Department of Cardiology; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
- Department of Medicine; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
| | - PAUL B. SPARKS
- Department of Cardiology; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
- Department of Medicine; The Royal Melbourne Hospital; University of Melbourne; Parkville Victoria Australia
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Affiliation(s)
- Shiao-Yen Khoo
- Resident in Internal Medicine, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, MN
| | - George W. Deimel
- Resident in Internal Medicine, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, MN
| | - John G. Park
- Adviser to residents and Consultant in Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
- Individual reprints of this article are not available. Address correspondence to John G. Park, MD, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905 ()
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Arora S, Chakravarthy M, Srinivasan V. CASE REPORTS: Delayed Manifestation of a Mid-Esophageal Tear with Profuse Hemorrhage after Transesophageal Echocardiogram. Echocardiography 2007; 25:328-30. [DOI: 10.1111/j.1540-8175.2007.00597.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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Raman SV, Cook SC. Cardiovascular computed tomography and MRI in clinical practice: aortopathy. J Cardiovasc Med (Hagerstown) 2007; 8:535-40. [PMID: 17568289 DOI: 10.2459/01.jcm.0000278444.66494.c1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The aorta serves as a lifeline for arterial supply throughout the body, the site of potentially fatal mechanical complications, and a mechanistic partner in hypertension and numerous cardiovascular diseases, thus meriting our careful attention. The following clinical vignette illustrates a case of aortic disease, paying homage to the aorta as we begin a series on cardiovascular imaging in the Journal of Cardiovascular Medicine. This series seeks to present contemporary approaches to diagnosis and management in cardiovascular medicine that include state-of-the-art imaging techniques guided by bedside clinical assessment. Incorporating volumetric multidetector computed tomography and dynamic MRI at various stages of this patient's care afforded the timely detection and management of her aortopathy.
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Affiliation(s)
- Subha V Raman
- The Ohio State University, Columbus, Ohio 43210, USA.
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