A toe in the esophagus.A 78-year-old woman who underwent an aortic valve replacement. During the procedure, transesophageal echography (TOE) was performed. The anesthetist was suspicious that the manoeuvre had not been straightforward. At the end of the operation a nasogastric tube was passed, but failed to drain gastric contents. A chest X-ray showed the tube coiled in the chest. A contrast study showed a major leak into the right chest. At operation a 2 cm defect was found in the mid-esophagus. This was repaired. The instrument is holding one edge of the esophageal tear.
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