Katz-Agranov N, Nevah Rubin MI. Severe esophageal injury after radiofrequency ablation - a deadly complication. World J Gastroenterol 2017; 23(18): 3374-3378 [PMID: 28566899 DOI: 10.3748/wjg.v23.i18.3374]
Corresponding Author of This Article
Nurit Katz-Agranov, MD, Department of Internal Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin, MSB 1.150, Houston, TX 77030, United States. nurit.s.katz@uth.tmc.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. May 14, 2017; 23(18): 3374-3378 Published online May 14, 2017. doi: 10.3748/wjg.v23.i18.3374
Severe esophageal injury after radiofrequency ablation - a deadly complication
Nurit Katz-Agranov, Moises I Nevah Rubin
Nurit Katz-Agranov, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, United States
Moises I Nevah Rubin, Department of Gastroenterology Hepatology and Nutrition, the University of Texas Health Science Center at Houston, Houston, TX 77030, United States
Author contributions: Katz-Agranov N reviewed the literature and wrote the paper; Nevah Rubin MI collected the patient’s clinical data and edited the paper.
Institutional review board statement: We confirm that case reports at our institution are exempt for institutional review board approval.
Informed consent statement: Informed consent was unobtainable because the patient was deceased, however all identifiable information was omitted or anonymized.
Conflict-of-interest statement: We confirm that all the authors listed above have participated in the preparation of this manuscript and that they have no conflict of interests, financial or otherwise.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Nurit Katz-Agranov, MD, Department of Internal Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin, MSB 1.150, Houston, TX 77030, United States. nurit.s.katz@uth.tmc.edu
Telephone: +1-713-5006500 Fax: +1-713-5006497
Received: November 22, 2016 Peer-review started: November 24, 2016 First decision: December 28, 2016 Revised: January 18, 2017 Accepted: February 7, 2017 Article in press: February 8, 2017 Published online: May 14, 2017 Processing time: 173 Days and 18.8 Hours
Abstract
Various degrees of esophageal injury have been described after radiofrequency ablation performed for treatment of atrial fibrillation. The main mechanism of injury is thermal and may lead to a range of esophageal mucosal changes, some clinically insignificant, however when deep ulceration occurs, this may be further complicated by perforation and mediastinitis, a rare but life threatening sequelae. We present a case of a severe esophageal injury leading to mediastinitis, with interesting endoscopic findings.
Core tip: We report a case of esophageal perforation complicated by mediastinitis. Our report demonstrates the clinical course of a rare, yet deadly complication of radiofrequency ablation, with unique endoscopic findings. We believe that this report and brief review of the literature will serve an important reminder of this complication and its consequences, requiring a high index of suspicion for early diagnosis and treatment. Our report also serves as a reminder that a unified approach to treatment has yet to be established.
