Cas CliniqueComplications pulmonaires après inhalation de gastrografine lors du contrôle radiologique des anastomoses œsophagiennesPulmonary complications after gastrografin inhalation during post-œsophageal anastomosis X-ray control

Tracheal penetration of water soluble contrast media (gastrografin) for X-ray control, after gastro-oesophageal anastomosis, resulted in acute pulmonary oedema in two patients. In this type of surgery, mediastinal dissection was responsible for recurrent nerve injury. Inhalation was due to this recurrent nerve palsy. The pulmonary oedema could be related to gastrografin high osmolarity. Therefore, to prevent this complication, previous laryngeal cavity examination is recommended before carrying out the X-ray investigations. In case of recurrent nerve paralysis, barium sulphate or lipiodol should be preferred because of their lack of effect on the lungs.