Artikel
To operate or not to operate
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Veröffentlicht: | 19. April 2011 |
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Gliederung
Text
Introduction – Objective: Though not long ago the management of choice of upper aerodigestive tract perforations was the surgical one [1], currently the nonoperative management is also advocated [2], [3]. This study aims at presenting a case report of pneumopericardium combined with pneumomediastinum.
Case report: A 27 year-old man visited the outpatient ward of our hospital suffering from sore throat and chest pain after diving. Neck crepitance was palpated, while in indirect laryngoscopy a tiny laceration was observed subglottically. In the plain X-ray films air was observed in most areas of the neck, in mediastinum and in pericardium. Pneumothorax was not observed. The patient was administered high concentration of oxygen plus antibiotics intravenously. No longer than six days later without any surgical intervention all findings disappeared.
Instead of conclusion: A surgeon is a doctor who knows how to operate. A good surgeon is one who knows when to operate. The best surgeon is the one who knows when not to operate.
References
- 1.
- Shockley WW, Tate JL, Stucker FJ. Management of perforations of the hypopharynx and cervical esophagus. Laryngoscope. 1985;95(8):939-41. DOI: 10.1288/00005537-198508000-00011
- 2.
- Dolgin SR, Wykoff TW, Kumar NR, Maniglia AJ. Conservative medical management of traumatic pharyngoesophageal perforations. Ann Otol Rhinol Laryngol. 1992;101(3):209-15.
- 3.
- Goudy SL, Miller FB, Bumpous JM. Neck crepitance: Evaluation and management of suspected upper aerodigestive tract injury. Laryngoscope. 2002;112(5):791-5. DOI: 10.1097/00005537-200205000-00005