Esophageal perforation and mediastinal gas gangrene developed in a 55-year-
old male after the endoscopic ethanol injection of a Mallory-Weiss ulcer. I
nitially, extensive gangrene of the esophagus and the mediastinum was treat
ed by esophagectomy; however, an abundance of Clostridium perfringens in th
e Gram stain verified the presence of gas gangrene. Subsequently, the patie
nt was transferred to a hyperbaric oxygen center, wherein a total of seven
hyperbaric treatments were administered. The patient survived, and 4 months
later, after having undergone several reoperations because of pleural empy
ema, mediastinal abscess, splenic rupture, and acalculous cholecystitis, wa
s discharged and is still surviving. (Ann Thorac Surg 2000;70:2143-5) (C) 2
000 by The Society of Thoracic Surgeons.