PubMed · 6607690
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E R Lutkus, A F Hirsch, J P Wood. 1984. Tetanus.. https://doi.org/10.1016/s0196-0644(84)80610-1
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A 54-year-old patient with polycystic kidney disease developed relapsing urinary-tract infections after renal transplantation. In the post-transplantation period he underwent two rejection episodes. The general condition worsened without obvious reason. Six months after transplantation the patient was hospitalized due to gram-negative sepsis. Despite adequate antimicrobial treatment he continued to lose weight and complained of dysphagia. Chest X-ray and computer tomogram of the thorax showed multiple cavitating infiltrations of the lung. A few days later the patient died from an extended subarachnoidal hemorrhage.
The incidence of oesophageal perforation in 350 patients referred for laser treatment to palliate malignant dysphagia is reported. Perforation occurred in 6 per cent of patients or 2 per cent of treatment episodes. Perforation was usually due to oesophageal dilatation undertaken before laser treatment (23 of 25 perforations). Immediate recognition and the institution of an aggressive non-operative management protocol resulted in survival in 20 of 23 patients.