To the Editor.—Because of its thin wall and comparative immobility, the esophagus is particularly susceptible to iatrogenic injury. In the following case, perforation occurred in an otherwise healthy patient during passage of a gastric bubble for weight control. To my knowledge, this is the first reported instance of perforation under these circumstances.
Report of a Case.—A 52-year-old man with a history of obesity but without previous medical problems underwent gastroscopy and elective insertion of a Garren gastric bubble (American Edwards Laboratories, Santa Ana, Calif) for weight reduction. During this procedure, which was performed in the gastroenterologist's office, the bubble was accidentally inflated in the distal esophagus; rupture ensued complicated by a right-sided tension pneumothorax. The patient collapsed from shock and required cardiopulmonary resuscitation. He was transferred to our institution for treatment.
On admission, the patient was in severe respiratory distress with cyanosis. He had a blood pressure of