PMC4748191_01
Chest x-ray from case 1 showing a large right-sided pneumothorax with an orogastric tube (arrows) malpositioned in the right hemithorax.
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F1
A chest x-ray revealed a large, right-sided pneumothorax with the orogastric tube malpositioned in the right hemithorax (Figure 1).
PMC4748191_02
PMC4748191_03
PMC4748191_04
Acute esophageal necrosis complicated by esophageal perforation due to orogastric tube placement. On upper endoscopy, black necrotic mucosa was found throughout the esophagus, and there was a disruption of the distal esophagus where the right pleural space could be entered with visualization of the right lung and parietal pleura. The free esophageal perforation was too large for endoscopic intervention.
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V1
Upper endoscopy revealed circumferential necrosis throughout the esophagus and a mid-esophageal stricture 5 cm in length that could not be traversed by the standard upper endoscope (Figure 2). His condition improved and he was discharged home, but continues to require serial dilations for a persistent esophageal stricture (Figure 2).
PMC4748191_05
PMC4748191_06
(A) The initial endoscopic appearance in case 4 showing black esophagus with diffuse and circumferential esophageal necrosis. (B) A severe esophageal stricture persisted even after healing, which required serial dilations to maintain patency.
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F2
Upper endoscopy revealed necrosis in the distal third of his esophagus (Figure 3).