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Esophageal perforation management and medical malpractice

Most of the time, a perforated esophagus is caused by a surgeon, physician or health care provider

Esophageal perforation is a dreaded rare complication of surgeries and procedures involving the neck.

What is the esophagus?

The esophagus is a muscular tube for the transport of food and liquids from the throat to the gastrointestinal tract. It’s located anterior (in front of) the spinal column and posterior (behind) the trachea, or windpipe.

How can the esophagus get perforated in the operating room?

Medical studies report that esophageal perforation has occurred in procedures including anterior cervical spine surgery, endoscopy (placement of a flexible scope with camera down the throat), and during intubation or extubation (placing or removing, respectively, an endotracheal tube down the throat for general anesthesia).

For endoscopy and extubation, the perforation often occurs because of physical trauma when the endoscope or endotracheal tube is physically maneuvered to the esophagus.

The mechanism of injury for anterior cervical spine surgery is a bit different. Many spine surgeries are performed with the patient in a prone position (belly down). An anterior spine surgery, though, is performed with the patient in a supine position (lying on the back). For an anterior surgical approach, the esophagus has to be mobilized or moved to reach the spinal column.

In anterior cervical spine surgeries, the surgeon must give great care not to damage the esophagus with aggressive or improper retraction (mobilization)

What are the potential consequences of esophageal perforation?

Surgeons, physicians, and patients alike are alarmed by esophageal perforation because of the serious problems that can cause. With prompt identification and treatment within 24 hours, the mortality (death) rate is still as high as 20%. When there is a delay in treatment, though, the mortality rate is close to 50%.

Medical studies have shown that it’s common for perforations of the esophagus to lead to critical or life-threatening injuries caused when the contents of the esophagus spill into the body (retropharyngeal and prevertebral spaces). These contents include food, bacteria, and digestive juices, which cause serious injuries including:

• Fistula formation: The leak of digestive juices can cause development of an abnormal passageway between two body parts or compartments

• Infections and abscesses

• Osteomyelitis: Bone swelling or inflammation

• Mediastinitus: Inflammation of the chest between the lungs (mediastinum)

• Sepsis: A dangerous systemic/body-wide inflammatory response to infection

• Death

If you or a loved one has been seriously injured because of esophageal perforation in Texas, then contact a top-rated experienced Texas medical malpractice lawyer for a free consultation about your potential case.

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.


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