Year 2024 / Volume 116 / Number 9
Letter
When eating becomes a real nightmare

513-514

DOI: 10.17235/reed.2023.10025/2023

Mara Sarmento Costa, Elisa Gravito-Soares, Marta Gravito-Soares, Cláudia Agostinho, Pedro Figueiredo,

Abstract
.We present the case of a 46-year-old female with dysphagia to solids and retrosternal pain that worsened after eating. Due to mediastinal lymphadenopathies, she underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) 3 weeks before, mentioning the complaints started afterwards. On physical examination she had fever (38.3ºC). Gastroscopy revealed three 10-20mm fistulous orifices with purulent discharge at 26-32cm from the incisors and another four partially covered by fibrin in the distal esophagus. EBUS-TBNA report was reviewed, mentioning 6 needle passes through the esophagus, due to failed endotracheal intubation, without immediate complications. A cervicothoracic CT scan identified 2 mediastinal abscesses, the largest with 9cm, communicating with the esophageal fistulas. She was admitted, underwent intravenous antibiotics and endoscopy-guided nasogastric tube placement. The histopathological analysis diagnosed Castleman’s disease. There was clinical and imagological improvement during admission. After 16 days she was released. Upper endoscopy was repeated one month later showing complete closure of the fistulous orifices.
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Sarmento Costa M, Gravito-Soares E, Gravito-Soares M, Agostinho C, Figueiredo P. When eating becomes a real nightmare. 10025/2023


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Publication history

Received: 19/10/2023

Accepted: 24/10/2023

Online First: 06/11/2023

Published: 09/09/2024

Article Online First time: 18 days

Article editing time: 326 days


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