[Fatal esophageal hemorrhage in patients with severe motor and intellectual disabilities complicated with severe scoliosis, during catheter placement in esophagus].

In patients with severe motor and intellectual disabilities (SMID), fatal esophageal hemorrhage including penetration of the descending aorta, has often been reported. We experienced 2 patients with severe scoliosis who developed esophageal hemorrhage during catheter placement in the esophagus. We compared chest CT images of these cases with those of 38 SMID patients in our hospital. As a result, a few patients showed esophagus bending to the left of the descending aorta while the vertebral body curved to the right and the mediastinum shifted to the left. It is suggested that there is a risk of esophageal hemorrhage caused by catheter stimulation, when a catheter is placed in the esophagus in such patients. It is therefore necessary to use the thinnest and softest catheter possible and to consider the indications for gastrostomy.