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Case Reports in Surgery
Volume 2015 (2015), Article ID 102540, 3 pages
http://dx.doi.org/10.1155/2015/102540
Case Report

Conservative Management of an Iatrogenic Esophageal Tear in Kenya

1Department of Surgery, St. Mary’s Mission Hospital, P.O. Box 3409, Nairobi 00506, Kenya
2Department of Surgery, The Karen Hospital, P.O. Box 74240, Nairobi 00200, Kenya

Received 19 April 2015; Revised 28 June 2015; Accepted 1 July 2015

Academic Editor: Steve de Castro

Copyright © 2015 Peter Waweru and David Mwaniki. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Since its description over 250 years ago, diagnosis of esophageal perforation remains challenging, its management controversial, and its mortality high. This rare, devastating, mostly iatrogenic, condition can quickly lead to severe complications and death due to an overwhelming inflammatory response to gastric contents in the mediastinum. Diagnosis is made with the help of esophagograms and although such tears have traditionally been managed via aggressive surgical approach, recent reports emphasize a shift in favor of nonoperative care which unfortunately remains controversial. We here present a case of an iatrogenic esophageal tear resulting from a routine esophagoscopy in a 50-year-old lady presenting with dysphagia. The esophageal tear, almost missed, was eventually successfully managed conservatively, thanks to a relatively early diagnosis.