Usefulness of Vacuum-Assisted Closure Therapy in the Treatment of Esophageal Perforation Following Thyroidectomy / 대한이비인후과학회지

Perforation of the cervical esophagus after thyroidectomy is a rare complication. Esophageal perforation is usually treated conservatively with simple surgical drainage and intravenous antibiotic therapy. If complicated by abscess, it needs aggressive surgery including resection and anastomosis. But the aggressive treatments mentioned have low success and high morbidity. Herein, we report a patient with complicated deep neck infection caused by esophageal perforation following thyroidectomy, which was successfully treated with multiple vacuum-assisted closure and intravenous antibiotic therapy after the failure of simple suture and simple drainage as conservative managements.

Perforación esofágica cervical en un anciano diabético / Cervical esophageal perforation in a diabetic elderly

Se describe el caso clínico de un paciente de 67 años de edad con antecedentes de diabetes mellitus, quien había ingerido una espina de pescado desde hacía 4 días y acudió al Cuerpo de Guardia del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, por presentar disfonía, disfagia para líquidos, impotencia funcional del cuello y fiebre de 38 ºC. Se le diagnosticó una perforación del esófago en la región cervical, por lo que fue ingresado y operado con urgencia; a los 6 días fue reintervenido para revisar la cervicotomía y realizar apertura de una fascitis séptica en el lado derecho del tórax. El paciente evolucionó satisfactoriamente y se le dio el alta a los 35 días de estancia hospitalaria.

The case report of a 67 years patient with a history of diabetes mellitus is described who had eaten a fish bone 4 days ago and went to "Saturnino Lora Torres" Teaching Clinical Surgical Provincial Hospital emergency room in Santiago de Cuba, due to disphony, disphagia for liquids, neck functional impotence and a 38 ºC fever. He had the diagnosis of an esophageal perforation in the cervical region, so he was admitted and operated as an emergency; 6 days later he underwent surgery again to check the cervicotomy and to carry out the opening of a septic fasciitis in the right side of the thorax. The patient had a satisfactory clinical course and he was discharged 35 days later.