Re: perforations?

[Guest guest]

Joy,

I had a small perforation after a balloon dilation. They didn't notice anything afterwards however, not long after I was home I became quite sick, vomiting and running a temperature. I went to the emergency room where I was admitted but they didn't actually find the perforation until the following day. They took a number of x-rays from different vantage points and found a tiny perforation that was consistent in all of the x-rays, fortunately for me it healed on its own, so no surgery was required.

Ed

perforations?

I'm wondering if anyone knows how quickly they would do a surgery if there is a perforation from a dilation? I got the impression that they do a barium swallow following the dilation to check for perforations, but I also thought I was told they would perform the surgery while you were still under anesthesia from the dilation. Are there different types of perforations? Those they can see right away as well as those they have to see through the barium swallow? And if they do do the dilation, then the barium swallow, do they do the surgery later the same day?thanksJoy in cloudy San

[Guest guest]

I asked a GI about some of this yesterday. He mentioned that in

some cases (I guess if the perforation seems small or very minor)

they can wait a few days to see if it closes on its own.

If it is more involved, I don't know how quickly they operate (I am

assuming in some cases it is immediately but don't know for sure).

Vicki

>

> I'm wondering if anyone knows how quickly they would do a surgery

if

> there is a perforation from a dilation? I got the impression that

they

> do a barium swallow following the dilation to check for

perforations,

> but I also thought I was told they would perform the surgery while

you

> were still under anesthesia from the dilation. Are there

different

> types of perforations? Those they can see right away as well as

those

> they have to see through the barium swallow? And if they do do

the

> dilation, then the barium swallow, do they do the surgery later

the

> same day?

>

> thanks

> Joy in cloudy San

>

[Guest guest]

Joy,

This is my undertsanding and I think reflects what was explained to me when I asked my doctor three weeks ago (I had a dilatation three weeks ago....I have manometry on Friday).

It essentially depends on where the perforation is.

You are correct in your thought that we have a check barium swallow post procedure. This will reveal any perforation and leakage that has been hidden during our recovery from the dilatation. Ordinarily, if we have been perforated we will have unresolved pain and may have an increase in temperature, but not always, hence the barium check.

There are also two types. A perforation in the chest is more dangerous than a perforation in the abdomen. Most of us have our sphincter entirely sitting in the abdomen, but for others the sphincter can straddle the diaphragm and of course hernias can also play their part in this.

As we are nil by mouth prior to the procedure our risks are reduced. Even if we have food/fluid retained in the oesophagus they will not proceed if it is dangerous. I actually had my last dilatation cancelled as my oesophagus was too full so I was admitted overnight and had a naso gastric tube passed to drain my oesophagus out completely.

I understand that abdominal perforations can be treated conservatively. ie, you will be admitted to hospital and the perforation will be allowed to heal itself. If you have a perforation in the chest then this will be dependant upon your physical signs and symptoms. You are correct in that this can occasionally warrent emergency surgery but each perforationa and each person is individual and it does vary.

I hope this helps.

STEVE

perforations?

I'm wondering if anyone knows how quickly they would do a surgery if there is a perforation from a dilation? I got the impression that they do a barium swallow following the dilation to check for perforations, but I also thought I was told they would perform the surgery while you were still under anesthesia from the dilation. Are there different types of perforations? Those they can see right away as well as those they have to see through the barium swallow? And if they do do the dilation, then the barium swallow, do they do the surgery later the same day?thanksJoy in cloudy San

[Guest guest]

Joy

In reference to your comment:

I'm trying to figure out if I have a dialation and a surgery is needed, could I have it at a different hospital.

I think this would depend on the severity of the perforation,

but I am not sure I would want to risk going somewhere

else if I was bleeding internally.

This was a matter of concern for me as I was deciding

to have a second dilatation. The hospital I use has one

surgeon I believe who has done a few lap, but has not

had a lot of experience. The one doctor who was

recommended to me to perform a VAT had done a

number of these but not one myotomy.

I did decide to have the dilatation, but I did it knowing

that if I was perforated that I'd be getting a surgeon

with not much experience. I won't go into all the things

that helped me make that decision in this mail.

Good luck,

Maggie

Alabama....where it just keeps getting hotter.

[Guest guest]

Thank you. I'm trying to figure out if I have a dialation and a

surgery is needed, could I have it at a different hospital.

Thanks, Joy

> >

> > I'm wondering if anyone knows how quickly they would do a

surgery

> if

> > there is a perforation from a dilation? I got the impression

that

> they

> > do a barium swallow following the dilation to check for

> perforations,

> > but I also thought I was told they would perform the surgery

while

> you

> > were still under anesthesia from the dilation. Are there

> different

> > types of perforations? Those they can see right away as well as

> those

> > they have to see through the barium swallow? And if they do do

> the

> > dilation, then the barium swallow, do they do the surgery later

> the

> > same day?

> >

> > thanks

> > Joy in cloudy San

> >

>

[Guest guest]

Steve,

It does help, thank you. This is one of those issues that the

doctors haven't said much about and I have a coulpe weeks before the

next appt - where I will be sure to grill them on the specifics

Joy

>

> Joy,

>

> This is my undertsanding and I think reflects what was explained

to me when I asked my doctor three weeks ago (I had a dilatation

three weeks ago....I have manometry on Friday).

>

> It essentially depends on where the perforation is.

>

> You are correct in your thought that we have a check barium

swallow post procedure. This will reveal any perforation and

leakage that has been hidden during our recovery from the

dilatation. Ordinarily, if we have been perforated we will have

unresolved pain and may have an increase in temperature, but not

always, hence the barium check.

>

> There are also two types. A perforation in the chest is more

dangerous than a perforation in the abdomen. Most of us have our

sphincter entirely sitting in the abdomen, but for others the

sphincter can straddle the diaphragm and of course hernias can also

play their part in this.

>

> As we are nil by mouth prior to the procedure our risks are

reduced. Even if we have food/fluid retained in the oesophagus they

will not proceed if it is dangerous. I actually had my last

dilatation cancelled as my oesophagus was too full so I was admitted

overnight and had a naso gastric tube passed to drain my oesophagus

out completely.

>

> I understand that abdominal perforations can be treated

conservatively. ie, you will be admitted to hospital and the

perforation will be allowed to heal itself. If you have a

perforation in the chest then this will be dependant upon your

physical signs and symptoms. You are correct in that this can

occasionally warrent emergency surgery but each perforationa and

each person is individual and it does vary.

>

> I hope this helps.

>

> STEVE

>

>

>

> perforations?

>

>

> I'm wondering if anyone knows how quickly they would do a surgery

if

> there is a perforation from a dilation? I got the impression that

they

> do a barium swallow following the dilation to check for

perforations,

> but I also thought I was told they would perform the surgery while

you

> were still under anesthesia from the dilation. Are there different

> types of perforations? Those they can see right away as well as

those

> they have to see through the barium swallow? And if they do do the

> dilation, then the barium swallow, do they do the surgery later

the

> same day?

>

> thanks

> Joy in cloudy San

>

[Guest guest]

Ed,

Thank you. I hadn't heard that some of them could heal on their

own... Glad to know our bodies can do some of their own healing!

LOL

Joy

>

> Joy,

> I had a small perforation after a balloon dilation. They didn't

notice anything afterwards however, not long after I was home I

became quite sick, vomiting and running a temperature. I went to the

emergency room where I was admitted but they didn't actually find

the perforation until the following day. They took a number of x-

rays from different vantage points and found a tiny perforation that

was consistent in all of the x-rays, fortunately for me it healed on

its own, so no surgery was required.

> Ed

> perforations?

>

>

> I'm wondering if anyone knows how quickly they would do a

surgery if

> there is a perforation from a dilation? I got the impression

that they

> do a barium swallow following the dilation to check for

perforations,

> but I also thought I was told they would perform the surgery

while you

> were still under anesthesia from the dilation. Are there

different

> types of perforations? Those they can see right away as well as

those

> they have to see through the barium swallow? And if they do do

the

> dilation, then the barium swallow, do they do the surgery later

the

> same day?

>

> thanks

> Joy in cloudy San

>