بعد ساعتين من توسيع المريء بالمنظار، يشتكي المريض من ألم في الصدر والرقبة يزيد مع البلع. عند لمس الرقبة يحس الممرض بفرقعة تحت الجلد. الحرارة ٣٨٫٠، النبض ١١٢. ما الذي يجب أن يشك فيه الممرض؟

Two hours after oesophageal dilatation, a client reports chest and neck pain worse on swallowing. The nurse feels crackling under the skin of the neck. T 38.0 °C, HR 112. What should the nurse suspect?

1. Normal post-endoscopy pain that resolves alone
2. Reflux caused by the long fast
3. Allergy to the local anaesthetic
4. Oesophageal perforation

Answer: D) Oesophageal perforation. Chest or neck pain with dysphagia, subcutaneous emphysema and fever after an oesophageal procedure indicate perforation until proven otherwise. Keep NPO and notify the provider immediately.