Sundays Esophageal Case

[Kenneth Rütz]

Dear List and k

How is the patients condition at this state?
Where is the leak?
-If distal, one could try a coverd wall-stent in order to occlude the 
leak, limit the risk of further contamination, and to resume oral 
feding. NPO means there is still saliva going down, thus a need for 
closure even in spite of oral decontamination...
The stent could removed at a later stage, when the patient is fully 
recovered.

Kenneth Rütz
MD. Ph.D,
Senior Registrar, General Surgery
Svendborg, Denmark.
> Two weeks ago, I presented a case of GSW to innominate artery and  esophagus. 
>  He remained afebrile and with normal WBC.   On Day 10  he was fed and spiked 
> a little fever.  Esophageal swallow showed a LITTLE,  TINY leak, but he was 
> put NPO, a jejunostomy tube inserted and his fever  disappeared.   The 
> ultrasound of the neck showed NO expansion of the  hematoma .   Have NOT done an 
> arteriogram.    
>  
> So we are going to NOT feed him for a couple of weeks and repeat the  
> swallow, feeding him via jejunostomy.  
>  
> k
>