<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2011-7582</journal-id>
<journal-title><![CDATA[Revista Colombiana de Cirugía]]></journal-title>
<abbrev-journal-title><![CDATA[rev. colomb. cir.]]></abbrev-journal-title>
<issn>2011-7582</issn>
<publisher>
<publisher-name><![CDATA[Asociación Colombiana de Cirugía]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2011-75822024000600989</article-id>
<article-id pub-id-type="doi">10.30944/20117582.2557</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Abordaje quirúrgico y endoscópico de un caso atípico de perforación esofágica espontánea]]></article-title>
<article-title xml:lang="en"><![CDATA[Surgical and endoscopic approach to an atypical case of spontaneous esophageal perforation]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Giraldo-Campillo]]></surname>
<given-names><![CDATA[Daniela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jaramillo-Escobar]]></surname>
<given-names><![CDATA[Sergio Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ruiz-Gallego]]></surname>
<given-names><![CDATA[Maryan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ricaurte-Ciro]]></surname>
<given-names><![CDATA[Juan Camilo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Antioquia Programa de especialización en Cirugía General ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital San Vicente Fundación Servicio de Cirugía General ]]></institution>
<addr-line><![CDATA[Rionegro ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital San Vicente Fundación Servicio de Gastroenterología ]]></institution>
<addr-line><![CDATA[Rionegro ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<volume>39</volume>
<numero>6</numero>
<fpage>989</fpage>
<lpage>997</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S2011-75822024000600989&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S2011-75822024000600989&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S2011-75822024000600989&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción.  La perforación esofágica se define como la ruptura transmural del esófago. Existen diferentes causas, como neoplásicas, traumáticas, lesión por cuerpos extraños, ingesta de cáusticos, iatrogénicas o espontáneas, denominadas Síndrome de Boerhaave. La tasa de mortalidad es alta y oscila entre 40-60 % con manejo óptimo, hasta el 100 % sin tratamiento.  Caso clínico.  Se presenta el caso de una paciente de 70 años, que ingresó por 5 días de sensación de globus faríngeo, disnea y dolor torácico. Se realizó una tomografía computarizada de tórax donde se visualizó un derrame pleural derecho, que fue manejado con toracostomía cerrada. Posteriormente, se visualizó la salida de material alimentario por la sonda de toracostomía, por lo que se hizo una nueva tomografía de tórax y abdomen encontrando una fístula esofagopleural. En una esofagografía por tomografía donde se vio extravasación del medio de contraste en la región infracarinal hacia espacio pleural derecho.  Resultados.  Fue llevada a toracotomía, encontrando empiema y atrapamiento del lóbulo inferior derecho por abundante fibrina, pus y restos alimentarios, secundario a perforación esofágica del tercio medio. Se practicó esofagorrafia, pleurectomía y decorticación. Se continuó manejo endoscópico con sistema de vacío de forma seriada.  Conclusiones.  Las perforaciones esofágicas son un desafío para los cirujanos, tanto en el enfoque diagnóstico inicial, como en el tratamiento. Conocer los abordajes endoscópico, quirúrgico y mixto ayuda a ampliar las opciones de manejo en estos pacientes. El tratamiento oportuno, las indicaciones no operatorias y las nuevas medidas endoscópicas para el manejo impactan en la mortalidad.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction.  Esophageal perforation is defined as a transmural rupture of the esophagus. There are different causes, such as neoplastic, traumatic, foreign body, caustic ingestion, iatrogenic or spontaneous, called Boerhaave Syndrome. The mortality rate is high and ranges between 40-60% with optimal management, up to 100% mortality without treatment.  Clinical case.  The case of a 70-year-old patient is presented, who was admitted after five days of pharyngeal globus sensation, dyspnea, and chest pain. A CT scan of the chest was performed were a right pleural effusion was observed, which was managed with closed thoracostomy. The exit of food material through the thoracostomy tube was observed. Subsequently, a new CT scan of chest and abdomen was performed, finding an esophagopleural fistula. In a CT esophagography where extravasation of contrast medium was seen in the infracarinal region into the right pleural space.  Results.  She was taken to thoracotomy, finding empyema and entrapment of the right lower lobe due to abundant fibrin, pus and food debris, secondary to esophageal perforation of the middle third. Esophagorrhaphy, pleurectomy and decortication were performed. Endoscopic management with a vacuum system was continued on a serial basis.  Conclusions.  Esophageal perforations are a challenge for surgeons, both in the initial diagnostic approach and in treatment. Knowing the endoscopic, surgical and mixed approaches helps to expand the management options in these patients. Timely treatment, non-operative indications and new endoscopic measures for management affect mortality.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[enfermedades del esófago]]></kwd>
<kwd lng="es"><![CDATA[perforación del esófago]]></kwd>
<kwd lng="es"><![CDATA[fístula esofágica]]></kwd>
<kwd lng="es"><![CDATA[endoscopía del sistema digestivo]]></kwd>
<kwd lng="es"><![CDATA[procedimientos quirúrgicos mínimamente invasivos]]></kwd>
<kwd lng="es"><![CDATA[toracotomía]]></kwd>
<kwd lng="en"><![CDATA[esophageal diseases]]></kwd>
<kwd lng="en"><![CDATA[esophageal perforation]]></kwd>
<kwd lng="en"><![CDATA[esophageal fistula]]></kwd>
<kwd lng="en"><![CDATA[digestive system endoscopy]]></kwd>
<kwd lng="en"><![CDATA[minimally invasive surgical procedures]]></kwd>
<kwd lng="en"><![CDATA[thoracotomy]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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