Bedside ultrasound-guided water injection assists endoscopically treatment in esophageal perforation caused by foreign bodies: A case report  

作　　者：Hua-Xing Wei Song-Yong Lv Bin Xia Kai Zhang Chen-Ke Pan 

机构地区：[1]Department of Ultrasound,The Fourth Affiliated Hospital of Zhejiang University College of Medicine,Yiwu 322200,Zhejiang Province,China [2]Department of Ultrasound,Jinyun County People’s Hospital,Lishui 321400,Zhejiang Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2023年第6期1240-1246,共7页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND Fishbone migration from the esophagus to the neck is relatively uncommon in clinical practice.Several complications secondary to esophageal perforation after ingestion of a fishbone have been described in the literature.Typically,a fishbone is detected and diagnosed by imaging examination and is usually removed by a neck incision.CASE SUMMARY Herein,we report a case of a 76-year-old patient with a fishbone in the neck that had migrated from the esophagus and that was in close proximity to the common carotid artery,and the patient experienced dysphagia.An endoscopically-guided neck incision was made over the insertion point in the esophagus,but the surgery failed due to having a blurred image at the insertion site during the operation.After injection of normal saline laterally to the fishbone in the neck under ultrasound guidance,the purulent fluid outflowed to the piriform recess along the sinus tract.With endoscopic guidance,the position of the fish bone was precisely located along the direction of liquid outflow,the sinus tract was separated,and the fish bone was removed.To the best of our knowledge,this is the first case report describing bedside ultrasound-guided water injection positioning combined with endoscopy in the treatment of a cervical esophageal perforation with an abscess.CONCLUSION In conclusion,the fishbone could be located by the water injection method under the guidance of ultrasound and could be accurately located along the outflow direction of the purulent fluid of the sinus by the endoscope and was removed by incising the sinus.This method can be a nonoperative treatment option for foreign body-induced esophageal perforation.

关 键 词：Esophageal perforation Foreign body removal FISHBONE Beside ultrasound-guided ENDOSCOPY Case report 

分 类 号：R655.4[医药卫生—外科学]