PMC6556829_01
Comparative pictures of the perforation before and after closure.. A. Upper gastrointestinal endoscopy reveals a large esophageal perforation located 30 cm from the incisors after TEE.. B. The perforation is completely closed at 22 days postoperatively.
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Upper gastrointestinal endoscopy confirmed esophageal perforation located 30 cm from the incisors (Fig. 1A), and gastrografin contrast revealed mediastinum leakage (Fig. 2). At 22 days postoperatively, endoscopic retrograde observation via gastrostomy revealed a healed perforation (Fig. 1B), and the cervical esophageal stump that was separated during surgery was connected; it became patent spontaneously (Fig. 3A).
Comparative pictures of the stricture area before and after endoscopic balloon dilatation.. A. The cervical esophageal stump separated during the surgery is now connected and patent spontaneously.. B. Stricture area after four sessions of dilation.
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After four sessions of dilation (Fig. 3B), she could orally consume food without additional surgery.
Surgical schema and mechanism of spontaneous patency of each esophageal stump.. The oral side of the esophageal stump leaked and caused local contamination; consequently, the anal side was broken and caused each stump to become connected and patent spontaneously.
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Currently, she can walk with assistance and has a good oral intake (Fig. 4).