Esophageal perforation, inflammatory mediastinitis and pseudoaneurysm of the thoracic aorta as potential complications of botulinum toxin injection for achalasia

Chao, Che yung, Raj, Ashok, Saad, Nivene, Hourigan, Luke and Holtmann, Gerald (2014) Esophageal perforation, inflammatory mediastinitis and pseudoaneurysm of the thoracic aorta as potential complications of botulinum toxin injection for achalasia. Digestive Endoscopy, 27 5: 618-621. doi:10.1111/den.12392


Author Chao, Che yung
Raj, Ashok
Saad, Nivene
Hourigan, Luke
Holtmann, Gerald
Title Esophageal perforation, inflammatory mediastinitis and pseudoaneurysm of the thoracic aorta as potential complications of botulinum toxin injection for achalasia
Journal name Digestive Endoscopy   Check publisher's open access policy
ISSN 1443-1661
0915-5635
Publication date 2014-12-01
Year available 2014
Sub-type Article (original research)
DOI 10.1111/den.12392
Volume 27
Issue 5
Start page 618
End page 621
Total pages 4
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing
Language eng
Abstract Primary achalasia is a motility disorder of the esophagus involving impaired relaxation of the esophageal sphincter and, in later stages, dilatation and aperistalsis of the tubular esophagus. Endoscopic botulinum toxin injection to the lower esophageal sphincter is an effective and safe option in the treatment algorithm of achalasia, particularly in high-surgical-risk patients. In the present case report, we describe a rare complication of esophageal perforation following botulinum injection, resulting in associated inflammatory mediastinitis and formation of a pseudoaneurysm in the descending aorta. To the authors' knowledge, this is the first report in the literature of this rare complication of endoscopic botulinum injection. A contributing factor might have been the use of an injecting device with a significantly longer adjustable needle. Endoscopists should remain clinically vigilant to the potential complications associated with this common procedure.
Keyword Achalasia
Aortic pseudoaneurysm
Botulinum toxin
Esophageal perforation
Mediastinitis
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Faculty of Health and Behavioural Sciences -- Publications
Official 2015 Collection
School of Medicine Publications
 
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