Esophageal Perforation During Transesophageal Echocardiography Managed Conservatively: A Case Report With a Review of the Literature on Management

Transesophageal echocardiography (TEE) is one of the cornerstones of cardiac imaging in inpatient and intra-operative settings. TEE is considered a safe procedure, but it may result in serious complications, such as esophageal injury, vocal cord paralysis, arrhythmia, hypotension, seizure, and cardiac arrest. Herein, we discuss one of the rare complications, esophageal perforation, and a conservative approach to managing the patient in a 64-year-old female who underwent a TEE prior to a scheduled valvular surgery. The same day, she returned to the emergency department with complaints of neck and left-sided chest pain. Further evaluation revealed an esophageal perforation. It was managed conservatively, with the use of antibiotics and nil-by-mouth placement. This case demonstrates that depending on the size of the defect, conservative approaches of management are a reasonable option and that not all cases will necessitate an emergent surgery.