Patients were allowed orally only after complete healing at anastomotic site documented by contrast oesophagography
. Severe pneumonitis and septicaemia in patients with major leak contributed to mortality.
was routinely performed when the foreign body was difficult to remove or appeared to be lodged in the oesophagus, or had a sharp edge.
was planned for confirmatory diagnosis.
Routine follow-up included physical examination, blood biochemical analysis, tumour markers (carcino-embryonic antigen, SCC antigen), a computed tomography scan, oesophagography
, ultrasonography and endoscopy.
Baker and Berdon (1) reviewed Klinkhamer's (2) 20 patterns and formulated 4 typical patterns on oesophagography (Table 1).
Features of complete vascular rings especially with right arch present Vascular Embryology Oesophagography Other findings anomaly Double aortic Persistence Bilateral Most common arch of 4th impressions on vascular ring branchial sides of anomaly.
has a high sensitivity in detecting vascular compression of the trachea and oesophagus, and is the investigation of choice in some centres to screen for suspected vascular compression.
The introduction of diagnostic tools such as oesophagography
, flexible endoscopy, angiography, colour flow Doppler imaging and multislice helical computed tomography has resulted in an increasing confidence in the ability to detect injuries in the neck.
is considered to be more sensitive for the diagnosis of the condition.
Angiography should be reserved for clinically stable patients who have signs of major vascular injuries in zone I or III, while oesophagography
, oesophagoscopy and bronchoscopy should be performed pre-operatively on patients with aerodigestive tract injuries.