The perforation was due to inadvertent injury of the esophagus that was deformed and distorted by a large calcified lymph node in the mediastinum during intraoperative TEE instrumentation.

• 其发生的主要原因是病人纵膈腔中有一大钙化淋巴结，且手术中使用经食道超音波造成食道被扭曲压迫所导致。