RESUMEN
Esophageal perforation (EP) can be a complication of radiofrequency ablation, a standard treatment for certain patients with drug-refractory atrial fibrillation. This article discusses the etiology, clinical manifestations, and diagnosis of EP, as well as nursing care for patients with EP.
Asunto(s)
Ablación por Catéter/efectos adversos , Perforación del Esófago/etiología , Perforación del Esófago/enfermería , Anciano de 80 o más Años , Fibrilación Atrial/cirugía , Enfermería de Urgencia , Perforación del Esófago/complicaciones , Perforación del Esófago/diagnóstico , Humanos , Masculino , Diagnóstico de EnfermeríaRESUMEN
Feeding tubes are commonly used in neonatal intensive care units, and their abnormal position seen on radiographs may indicate underlying serious problems. We recently cared for two infants who presented with clinical deterioration. An abnormally placed feeding tube seen on the chest radiograph revealed underlying serious conditions. The first case was an infant 29 weeks of age who presented with right-sided pneumothorax after birth. By history and a right-side-displaced orogastric (OG) tube, iatrogenic esophageal perforation was diagnosed. The second case was a 16-day-old infant who presented with recurrent vomiting. An OG tube extending into a cystic mass at the right cardiophrenic angle resulted in diagnosis of a herniated stomach with organoaxial-type volvulus, which required surgical repair. Both cases recovered uneventfully. As illustrated in these two rare cases, feeding tube position is not only important for feeding practice, but it also has diagnostic implications in newborn infants.
Asunto(s)
Nutrición Enteral/instrumentación , Nutrición Enteral/enfermería , Falla de Equipo , Perforación del Esófago/diagnóstico por imagen , Perforación del Esófago/enfermería , Esófago/diagnóstico por imagen , Tracto Gastrointestinal/anomalías , Hernia Hiatal/diagnóstico por imagen , Hernia Hiatal/enfermería , Enfermedad Iatrogénica , Unidades de Cuidado Intensivo Neonatal , Vólvulo Gástrico/diagnóstico por imagen , Vólvulo Gástrico/enfermería , Estómago/diagnóstico por imagen , Diagnóstico Diferencial , Esófago/anomalías , Femenino , Hernia Hiatal/congénito , Humanos , Recién Nacido , Masculino , Neumotórax/diagnóstico por imagen , Neumotórax/enfermería , Radiografía , UltrasonografíaRESUMEN
Boerhaave syndrome is a rarely occurring condition with a high mortality rate if not diagnosed in a timely manner. Patients with this condition complain primarily of chest pain, and practitioners should consider esophageal rupture as a differential diagnosis during the initial diagnostic evaluation. Most treatment modalities have been derived from case studies, as there are no published reports on randomized controlled trials specifically dedicated to the treatment of Boerhaave syndrome. This case presentation includes the pathophysiology of esophageal rupture and the management pathways that have been shown to be successful based on current literature.
Asunto(s)
Dolor en el Pecho/etiología , Cuidados Críticos , Perforación del Esófago/complicaciones , Perforación del Esófago/enfermería , Enfermedades del Mediastino/complicaciones , Enfermedades del Mediastino/enfermería , Evaluación en Enfermería , Adulto , Diagnóstico Diferencial , Perforación del Esófago/diagnóstico , Femenino , Humanos , Enfermedades del Mediastino/diagnóstico , Rotura EspontáneaRESUMEN
The thoracic perioperative specialty team members at Inova Fairfax Hospital, Falls Church, Va, designed guidelines to improve the management of patients with esophageal perforations. They performed a retrospective analysis of 41 patients who were diagnosed with thoracic esophageal perforations from Sept 1, 1979, through Sept 1, 1996. The review affirmed their philosophy of aggressive, surgical intervention for perforations, particularly for patients diagnosed early (i.e., within 24 hours). The process of examining and communicating the results among OR nurses, anesthesia care providers, and surgeons resulted in the increased efficiency and appropriateness with which patients were incorporated into the hospital's surgical and medical treatment groups.