Early and late suspected instrumental esophageal perforation is assessed first by:
Correct Answer: CT scan
Description: Ans. (b) CT ScanRef Bailey and Love 27h edition Page 1073/1074Instrumental Perforation:* Most common cause of esophageal perforation.* In upper GI scopy incidence =1:4000* Factors increasing risk of perforation:# Large anterior Cervical osteophytes# Pharyngeal pouch# Mechanical obstructions# Following biopsy of malignancy* Therapeutic endoscopy has 10 times increased risk than diagnostic studies* Cervical perforation manifests immediately as localized pain in neck, hoarseness, painful neck movements, subcutaneous emphysema* Intrathoracic or intra-abdominal perforations presents with chest pain, hemodynamic instability, oxygen desaturation, evidence of perforation visually, abdominal pain, etc.* Some patients present late at 24 hours with pyrexia and sepsis. Diagnosis:* Most cases diagnosed immediately by a chest X-ray.* If not recognized, early and late suspected perforations should be assessed by CT (which shows air or leaked oral contrast and any fluid collection).(Authors Point- Direct Line from Bailey in NBE. If you read Bailey Line by Line Surgery part of NBE paper is nothing)* If CT is not available - Water soluble contrast is advised but it cannot detect small leaks always* If water-soluble contrast negative and you have strong suspect do dilute barium swallow
Category:
Surgery
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now