Esophageal perforation after transesophageal echocardiogram

Esophageal rupture after transesophageal echocardiogram (TEE) is a rare but life-threatening complication. Risk factors for perforation include spasm or hypertrophy of the cricopharyngeal sphincter, cervical arthritis, forwar d and left Lateral bending of the distal esophagus, and esophageal disease such as inflammation or neoplasm. We present the case of a 80-year-old woma n who developed perforation of her esophagus after TEE. Prior irradiation t o the chest due to treatment for breast cancer and subsequent fibrosis prob ably contributed to this complication. Physicians referring patients for a TEE and physicians performing this procedure should be aware for the risk o f perforation. The identification of risk factors and gentle maneuvering of the probe may prevent this severe, life-threatening complication.