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Delayed presentation of intrathoracic esophageal perforation after pneumatic dilation for achalasia

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Author(s): Ming-Tzung Lin, Wei-Chen Tai, King-Wah Chiu, Yeh-Pin Chou, Ming-Chao Tsai, Tsung-Hui Hu, Chuan-Mo Lee, Chi-Sin Changchien, Seng-Kee Chuah

Journal: World Journal of Gastroenterology
ISSN 1007-9327

Volume: 15;
Issue: 35;
Start page: 4461;
Date: 2009;
Original page

Keywords: Intrathoracic esophageal perforation | Delayed presentation | Pneumatic dilation | Esophageal achalasia

ABSTRACT
Pneumatic dilation (PD) is considered to be a safe and effective first line therapy for achalasia. The major adverse event caused by PD is esophageal perforation but an immediate gastrografin test may not always detect a perforation. It has been reported that delayed management of perforation for more than 24 h is associated with high mortality. Surgery is the treatment of choice within 24 h, but the management of delayed perforation remains controversial. Hereby, we report a delayed presentation of intrathoracic esophageal perforation following PD in a 48-year-old woman who suffered from achalasia. She completely recovered after intensive medical care. A review of the literature is also discussed.
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