PMC3618096_01
Endoscopy demonstrated complete necrosis from the hypopharynx to the pylorus. a Hypopharynx (upper part: tracheal tube). b Esophagus. c Gastric corpus. d Gastric antrum.
crg-0007-0089-g01.jpg
PMC3618096_01_crg-0007-0089-g01.jpg
F1
An emergency gastroscopy was performed, which showed complete necrosis of the hypopharynx, esophagus and stomach (grade 3b according to Zargar et al.) (fig. 1).
CT scan of the chest and abdomen demonstrated tension pneumothorax (a, b), necrotic esophagus (b, white arrowheads), necrotic pleural effusion (b, black arrows) and gastrointestinal perforation with free air in the abdominal cavity (c, d). e Frontal reconstruction of the CT scan.
crg-0007-0089-g02.jpg
PMC3618096_01_crg-0007-0089-g02.jpg
F2
Therefore, a CT scan was performed, demonstrating gastric perforation with free abdominal air, retroperitoneal air, multiple hypodense lesions of the liver and left-sided tension pneumothorax with pleural effusion and mediastinal necrosis (fig. 2).
Intraoperative view of exploratory laparoscopy showing the complete necrotic intestine.
crg-0007-0089-g03.jpg
PMC3618096_01_crg-0007-0089-g03.jpg
F3
Here she showed a completely necrotic stomach, small and large intestine without any therapeutic options (fig. 3).