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Esophageal Perforation and Mediastinal Abscess: An Unusual Complication of Endotracheal Intubation

Kitkungvan, Danai MD*; Pukiat, Sulada MD*; Targonska, Bogna MD; Popkin, Joel H. MD*

Clinical Pulmonary Medicine: May 2010 - Volume 17 - Issue 3 - p 152-153
doi: 10.1097/CPM.0b013e3181da83fa
Images in Pulmonary Medicine

Esophageal perforation is a life-threatening condition which can lead to development of mediastinal abscess, systemic infection and, ultimately, multiorgan failure and death. Esophageal instrumentation is currently the most common cause of esophageal perforation, while endotracheal intubation accounts for only a small number of cases. We report a case of silent esophageal perforation and mediastinal abscess after a difficult endotracheal intubation, successfully managed by nonoperative treatment.

Esophageal perforation is an unusual but life-threatening complication of endotracheal intubation. Signs and symptoms of patients with esophageal perforation can be nonspecific. Radiographic studies are very useful tools in establishing the diagnosis.

From the Departments of *Medicine and †Radiology, Saint Vincent Hospital, Worcester, MA.

Address correspondence to: Danai Kitkungvan, MD, Department of Medicine, St. Vincent Hospital, Worcester, MA 01608. E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.