Simultaneous surgical management of iatrogenic pharyngeal perforation and distal esophageal malignancy

Abstract

Instrumental perforation of the pharynx with distal obstruction is a complex problem. A fistula is not likely to close in the presence of distal obstruction. The stenotic lesion needs to be treated in addition to the perforation. We report a 83-year-old female patient who underwent three-stage total esophagectomy and right cervical pharyngo-gastric anastomosis for iatrogenic pharyngeal perforation and distal esophageal malignancy. The radical surgical approach has the advantage of treating the immediate crisis due to perforation and also treating the stricture for which the esophagoscopy was originally performed.