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Esophageal perforation status post stenting and repair, lumen of right causing partial luminal attenuation. Meaning?

Follow»up case of esophageal perforation status post stenting and repair. Approx. 13mm long and 5. 5mm wide detect is seen in the nght lateral wall of lower dorsal esophagus (at the level of D7 vertebral body). The lumen of the esophagus is directly communicating with the right pleural space. Stent is present within the lower hall of the esophagus from the level of carina and extending distally into the stomach. Minimal orally administrated contrast is seen outside the stent in its left lateral aspect. The contrast appears to leak into the pleural space, _ Majority of the orally administrated contrast is passing distally into the gastnc tube (fol/ow-up case of sleeve gastrectomy ), No evidence of leakage of contrast seen from the stomach. The gastric tube appears grossly normal rn morphology. Proximal esophagous is normal in morphology. _ _ A Loculated collection of size about 11.2 x 5.3x 10cm is seen in the lower Palf 0ff1Ql1l pleural space. lntercostal drainage tube is seen in situ. for rs] preseniwrthln the C0/ISCIIOH The oral contrast leaked from the esophagus IS 0l16f{lfYl 9 f 9 C0 9° O - h Associated tibroatelectatic changes are seen in nght lower lobe lung parenc yma. Mild tibrotic changes are also seen in the lol? lower lobe. Rest ofthe lung parenchyma showi n0n;;:,;°,%|:1; ?1?e¥ect of size about 3.3 x 0.8cm is seen within the lumen of right A VPU hlch is causing partial luminal attenuation- suggestive of pulmonafl’ art? }’, v|;t 8 ears to extend into one ofthe segmental branches. thromboeI1 lb0/ 5” pp - hows grossly normal luminal enhancement, | Qnary arterial tree s , in Rest of the pu m ‘ I vascular stmctures are normal. Trachea and :ls ma A The heart & the msggzggf No evidence gf mediastinal lymphadenopathy seen, Hrlar h` I divisions ar ~ §;t$.Ir:$“:Ul{;S reveal normal morphology.
Asked On : Tue, 12 Feb 2013
Answers:  1 Views:  703
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Internal Medicine Specialist 's  Response
Dear friend, welcome and thanks for entrusting your query here at Healthcaremagic!
I am Dr. Prasad Akole (Critical Care Expert- and am glad to address to your query here.

The contents in the report here are partly distorted and hence difficult to comment on.

However, I gather that this is a case of sleeve gastrectomy (stomach resection) and the oesophageal perforation (food pipe rupture) which was stented.

The stent keeps the tube open allows healing over it as a support.

There is evidence of right lung damage/ collapse as a result of leakage of acid/ contents from the ruptured oesophagus (food pipe). A drainage tube is placed in the chest cavity to drain a collection of fluid near the lower end of the food pipe which ruptured into the lung space.
?partial lung vessel blockage seen (report misprinted)

These are changes secondary to rupture and are well treated. The stomach tube shows no leak.

The mediastinum looks normal (otherwise one expects a severe mediastinitis- a life threatening inflammation there) in such cases.

Healing takes time and may undergo complications.

Please be guided by the team of experts treating the case.

I hope to have answered your query satisfactorily. I would be glad to answer any further queries. Please ask for any clarifications before closing and rating this query.
Take care and please keep me informed of your progress at
Good Luck! Thank you!!
Answered: Thu, 4 Apr 2013
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