Oesophageal perforation during transoesophageal echocardiography.

Known for its reliability, transoesophageal echocardiography is an investig ation which is increasingly used in cardiology, cardiac surgery and intensi ve care units. It is a semi-invasive investigation of which oesophageal per fortation is a very rare but serious complication. Two cases of oesophageal perforation after transoesophageal echocardiograph y are reported out of a series of 87 oesophageal perforations treated betwe en January 1981 and February 1999. In both cases, transoesophageal echocard iography was performed in conscious patients without known pre-existing oes ophageal pathology. The presentations were acute. Both patients underwent e mergency surgery. One patient is alive and the other one died one month aft er a second operation related to the perforation. Nine cases of oesophageal perforation have been reported after transoesopha geal echocardiography. The pathogenesis, means of prevention and treatment of oesophageal perforation are discussed.