Successful Three-Stage Ethanol Ablation of Esophageal Mucocele

Corrosive injury of the upper gastrointestinal tract: the evolving role of a radiologist

Corrosive injury is a devastating injury which carries significant morbidity. The upper gastrointestinal tract is predominantly affected with severity ranging from mild inflammation to full thickness necrosis which may result in perforation and death. Among the complications, stricture formation is most common, causing dysphagia and malnutrition. Endoscopy has a pivotal role in the diagnosis and management, with a few shortcomings. Imaging has an important role to play. Besides radiography, there is an increasing role of CT scan in the emergency setting with good accuracy in identifying patients who are likely to benefit from surgery. Further, CT scan has a role in the diagnosis of complications. Oral contrast studies help in assessing the severity and extent of stricture formation and associated fistulous complications in the subacute and chronic phase. The scope of intervention radiology for this condition is increasing. Fluoroscopy-guided balloon dilatation, drainage of collections or mucoceles, endovascular embolization of point bleeders, placement of feeding jejunostomy and image-guided biopsy are among the procedures that are being performed. Through this review we aim to stress the role the radiologist plays in the diagnosis and follow-up of these patients and in performing radiological interventions. Besides this, we have also highlighted few salient points to help understand the pathophysiology and management of such injuries which is paramount to ensure a good long-term outcome.

Spontaneous Rupture of an Esophageal Mucocele Into the Airway

An esophageal mucocele is an uncommon complication after exclusion surgery of the thoracic esophagus. Although asymptomatic in most cases, it can progressively enlarge in size to cause symptoms requiring intervention. Occasionally, spontaneous decompression of its contents into the neck, mediastinum, peritoneal cavity, or tracheobronchial tree can occur, leading to potentially serious complications. We present a case of symptomatic esophageal mucocele after esophageal exclusion, complicated by the formation of an esophagobronchial fistula.