An interventional radiology technique to treat pharyngeal or esophageal perforation associated with mediastinal abscess in children
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In brief
In brief
Transnasal placement of mediastinal drainage catheters with nasojejunal feeding tubes offers a minimally invasive approach to pharyngeal or esophageal perforation with mediastinal abscess in children. In 14 pediatric patients, fistulas healed after median 66 days with no recurrence at 4-month follow-up, demonstrating this interventional radiology technique as safe and effective.
Written by the GCMD Library team from the article.
Purpose
Pharyngeal or esophageal perforation with mediastinal abscess is notably dangerous in children and can be very difficult to treat. We aimed to determine the safety and efficacy of the transnasal placement of a mediastinal drainage catheter and a nasojejunal feeding tube, with or without gastric decompression, in the treatment of the above perforations in children.
Methods
We placed transnasal mediastinal drainage catheters and nasojejunal feeding tubes in 14 pediatric patients. Patients with esophageal perforation also underwent the placement of a gastric decompression tube. Four of these patients additionally received chest drainage tubes.
Results
The fistula healed after a median of 66 days (range, 5–404 days). Corrosive esophagitis occurred in two patients with pharyngeal perforations. One of these patients underwent surgical treatment 2 months after fistula healing, and the other underwent repeated balloon dilatation procedures for cicatricial restenosis. Four months after the fistula had healed, the patients with esophageal perforations were all free from recurrence.
Conclusion
The use of interventional radiology to place a transnasal mediastinal drainage catheter, a nasojejunal feeding tube, and a gastric decompression tube is a safe, easy, inexpensive, and efficacious way to treat pharyngeal or esophageal perforation complicated by mediastinal abscess in children.
Type of study
Treatment study.
Level of evidence
Level IV.