[Perforation of hypopharynx -- a uncommon complication of transesophageal endosonography].

BACKGROUND

Today the endoscopical sonography of the oesophagus and heart is a useful diagnostic procedure. Perforations of the oesophagus or hypopharynx after this procedure are grave and life-threatening complications of this invasive diagnostic procedure.

MATERIAL AND

METHODS

In the past 8 years we observed 3 cases of hypopharyngeal perforation as complication of endosonographic procedure. These cases were evaluated retrospectively.

RESULTS

In all 3 cases an increased resistance against insertion of the probe had been observed. In two cases the perforation was found in the right sinus piriformis. The third patient had a perforation of the posterior hypopharyngeal wall adjacent to the upper oesophageal sphincter. The former patients underwent an open transcervical revision, in the latter patient the perforation was clipped endoluminally to his impaired general condition.

CONCLUSIONS

Perforations of the hypopharynx represent a rare but potentially life threatening complication of transoesophageal sonography. The endoscopically working physician should know and recognize the clinical signs for surgical treatment before further complications (e. g. mediastinitis) may occur.