Perforation of esofagic mucosa for enteric tube: case report

• Published in: Revista Brasileira de terapia intensiva 2006-03, Vol.18 (1), p.104-108
• Main Authors: Santos, Cynthia Clabunde Dos, Omura, Felipe, Guimarães, Hélio Penna, Falcão, Luiz Fernando Dos Reis, Lopes, Renato Delascio, Saes, Letícia Sandre Vendrame
• Format: Article
• Language: Portuguese
• ISSN: 0103-507X

This study is a case report of a patient that was submitted to implant of enteric tube (ET) in the ICU, being evidenced false passage in proximal esophagus during endoscopic procedure, demonstrating tunnel for the submucosa. A 77 years old woman, transferred to ICU, where ET was installed (due to difficulty of being carried through both nostrils) being confirmed its position through thoraco-abdominal x-ray. The patient remained around 10 days with the ET, receiving diet, without any alteration. In the 10th day she was evolved with melena and reduction of the values of Hb/Ht, without hemodynamic repercussion. Submitted to the high digestive endoscopic that evidenced ulcer injury to bulbar, of about 2.5 cm, with signals of former bleeding. During the examination, a false passage of the ET in proximal esophagus was visualized: 2 cm below of the crico-faring, tunnel for the submucosa possibly for all above-mentioned segments, following its habitual passage until gastric chamber. Patients of high risk for esophagus perforation for ET installation can be identified and well-taken care of adjusted they can be used. If to occur perforation, this must be identified how much so early possible, for adequate treatment. The adequate treatment depends of each case and same the clinical therapy can be appropriate in selected cases.