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Jahangir A, Sahra S, Anwar S, Mobarakai N, Jahangir A. Catastrophic right-sided Candida empyema from spontaneous esophageal perforation. Respir Med Case Rep 2021; 33:101460. [PMID: 34401296 PMCID: PMC8349041 DOI: 10.1016/j.rmcr.2021.101460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/27/2021] [Accepted: 06/15/2021] [Indexed: 11/21/2022] Open
Abstract
Right-sided empyema secondary to esophageal rupture are rare but reported in the medical literature. We describe an atypical CASE of right-sided empyema with Candida Tropicalis, Candida Glabrata, and Staphylococcus lugdenensis leading to a diagnosis of spontaneous esophageal rupture. We concluded that pleural effusion with fungal and multi-organism growth should immediately raise suspicion for underlying missed esophageal perforation. Prompt diagnosis of esophageal perforation can prevent fatal complications like pleuritis, pneumothorax, hydrothorax, pneumomediastinum, mediastinitis, acute respiratory distress syndrome, and septic shock.
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Affiliation(s)
| | - Syeda Sahra
- Staten Island University Hospital, Staten Island, NY, 10305, USA
| | - Shamsuddin Anwar
- Staten Island University Hospital, Staten Island, NY, 10305, USA
| | | | - Ahmad Jahangir
- King Edward Medical University, Lahore, Punjab, 54000, Pakistan
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Agrawal V, Aggarwal D. Undiagnosed spontaneous oesophageal rupture presenting as right hydropneumothorax. Indian J Thorac Cardiovasc Surg 2019; 35:111-114. [PMID: 33060987 DOI: 10.1007/s12055-018-0719-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/06/2018] [Accepted: 07/16/2018] [Indexed: 05/30/2023] Open
Abstract
Spontaneous oesophageal rupture has been a known ailment with a high morbidity and mortality. Various factors contribute to its predisposition such as preexisting oesophageal diseases, increased intraluminal pressure, neurogenic causes, and iatrogenic-commonest being instrumentation. We present the case of a 26-year-old male with features of right hydropneumothorax for which an intercostal chest drain (ICD) was inserted that yielded turbid fluid with suspicion of it being gastric contents. With a diagnosis of diaphragmatic hernia and gut/bowel injury caused due to intercostal drain, the patient underwent emergency exploratory laparotomy. No abnormality was detected and possibility of oesophageal injury/rupture was contemplated though ruled out on investigations. The patient improved with medical treatment of empyema and discharged. The patient was lost to follow-up until after a year the patient reported to surgery OPD with complaints of dysphagia. A barium swallow revealed thoracic oesophageal benign stricture thus confirming our suspicion of spontaneous oesophageal rupture that had occurred a year ago. Knowledge about atypical presentations of oesophageal rupture is important so as to be more aware of this possibility.
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Affiliation(s)
- Vivek Agrawal
- Department of Surgery, University College of Medical Sciences, Delhi, 310 SFS DDA Flat, Hauz Khas Apartments, Aurobindo Marg, New Delhi, 110016 India
| | - Deepanshu Aggarwal
- Department of Surgery, University College of Medical Sciences, Delhi, 35 Vigyan Vihar, Delhi, 110092 India
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Shao ER, Joseph PM, Slootweg P, Mkwizu EW, Kilonzo KG, Mwasamwaja AO. Spontaneous oesophageal rupture: a diagnostic challenge in resource-limited setting. Oxf Med Case Reports 2015; 2015:314-6. [PMID: 26421158 PMCID: PMC4584513 DOI: 10.1093/omcr/omv048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 07/05/2015] [Indexed: 11/13/2022] Open
Abstract
Spontaneous oesophageal rupture after swallowing a bolus of food is a very rare condition. In resource-limited settings, it is very challenging to diagnose this condition especially when its presentation is atypical. Its prognosis is very poor when diagnosis is delayed due to risk of mediastinitis. We report a case of 37-year-old man who was admitted to our hospital complaining of sudden onset of chest tightness and pain after a meal 8 h prior to admission. Urgent chest radiograph revealed right hydropneumothorax with collapsed lung. Water-seal drainage was established gushing 1200 ml of food materials. Definitive diagnosis of oesophageal rupture was reached after post-mortem.
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Affiliation(s)
- Elichilia R Shao
- Department of Internal Medicine , Kilimanjaro Christian Medical Center , Moshi , Tanzania ; Kilimanjaro Christian Medical University College , Moshi , Tanzania ; Image Doctors International , Arusha , Tanzania ; Better Human Health Foundation , Moshi , Tanzania
| | - Pantaleo M Joseph
- Department of Internal Medicine , Kilimanjaro Christian Medical Center , Moshi , Tanzania ; Kilimanjaro Christian Medical University College , Moshi , Tanzania
| | - Piet Slootweg
- Department of Pathology , Kilimanjaro Christian Medical Center , Moshi , Tanzania ; Department of Pathology , Radboud University Medical Centre , Nijmegen , the Netherlands
| | - Elifuraha W Mkwizu
- Department of Internal Medicine , Kilimanjaro Christian Medical Center , Moshi , Tanzania ; Kilimanjaro Christian Medical University College , Moshi , Tanzania ; Better Human Health Foundation , Moshi , Tanzania ; Endoscopy Unit , Kilimanjaro Christian Medical Center , Moshi , Tanzania
| | - Kajiru G Kilonzo
- Department of Internal Medicine , Kilimanjaro Christian Medical Center , Moshi , Tanzania ; Kilimanjaro Christian Medical University College , Moshi , Tanzania ; Endoscopy Unit , Kilimanjaro Christian Medical Center , Moshi , Tanzania
| | - Amos O Mwasamwaja
- Department of Internal Medicine , Kilimanjaro Christian Medical Center , Moshi , Tanzania ; Kilimanjaro Christian Medical University College , Moshi , Tanzania ; Image Doctors International , Arusha , Tanzania ; Better Human Health Foundation , Moshi , Tanzania ; Endoscopy Unit , Kilimanjaro Christian Medical Center , Moshi , Tanzania
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