Tracheal necrosis, oesophageal fistula: unusual complications of thyroidectomy. Report of two case and literature review.
Giovanni Conzo 1, Francesco Sanzione 1, Cristina Della Pietra 1, Antonietta Palazzo 1, Giuseppe Candilio 1, Alfonso Fiorelli 1, Mario Santini 1
Affiliation
Article Info
1 Unità di Chirurgia Toracica, Dipartimento di Internistica Clinica e Sperimentale “Magrassi-Lanzara”, Seconda Università degli Studi di Napoli, VII Divisione di Chirurgia Generale, Dipartimento di Scienze Anestesiologiche, Chirurgiche e dell’Emergenza, Seconda Università degli Studi di Napoli
Abstract
BACKGROUND: Thyroidectomy is considered a low-risk operation. The authors report a case of tracheal necrosis after total thyroidectomy for multinodular goiter with bilateral adenomas, and a case of oesophageal fistula after total thyroidectomy for papillary cancer. METHODS AND RESULTS: The patient with tracheal perforation was treated by a non operative management after clinical stabilization. The patient with oesophageal perforation underwent surgical treatment consisting of neck drain placement. Both patients are alive after 12 months of follow-up, although the patient who had surgery for papillary cancer of the thyroid gland was found to have multiple diffuse liver and lung metastases. CONCLUSIONS: Thyroidectomy is a safe surgical procedure, but in some patients major complications may arise. In cases of iatrogenic tracheal or oesophageal perforation, conservative non-surgical or conservative surgical treatment, in specialized centers, results in a favourable outcome. The authors discuss the risk factors and management of these two rare complications
Keywords
- Esophageal fistula
- Esophageal perforation
- Pneumomediastinum
- Thyroidectomy
- Tracheal necrosis.