Application of endoscopic vacuum-assisted closure therapy for oesophageal perforation: first case report in East Africa

Oesophageal perforation is a critical condition associated with high morbidity and mortality, requiring rapid diagnosis and effective treatment. Endoscopic vacuum-assisted closure (EVAC) therapy has emerged as an innovative and effective approach for managing oesophageal perforations, offering advantages such as enhanced healing shorter hospital stay and reduced complications. We report a case of oesophageal perforation complicated by subcutaneous emphysema, pleural effusions, and mild pneumothorax in a 40-year-old woman who presented with facial, neck, and chest swelling, dyspnoea, dysphagia, and fever following intubation during laparoscopic gynaecological surgery. Imaging revealed a defect in the oesophageal wall at the C5-C6 level with significant contrast extravasation and air tracking. Emergency surgical interventions, including chest tube placement, were performed, followed by a multidisciplinary treatment plan incorporating EVAC therapy. Post-treatment imaging demonstrated complete resolution of the perforation and associated complications. This case highlights the utility of EVAC therapy as a safe and effective modality in the comprehensive management of oesophageal perforation, underscoring its role in improving patient outcomes. EVAC therapy represents a promising approach for managing oesophageal perforations. It offers a minimally invasive alternative to traditional surgical treatment in resource-limited settings. This modality can potentially enhance healing, reduce complications, and lower costs.