Skip to main content

Esophageal Perforation

  • Chapter
Pediatric Thoracic Surgery

Abstract

Of all the perforations of the alimentary tract, perforations of the esophagus are considered the most dire and life-threatening. Historically, esophageal perforations in children were treated with highly invasive procedures in similar fashion to those carried out in adults. However, we have learned that esophageal perforations in children are: (i) more often iatrogenic, (ii) more likely to occur within the cervical esophagus, and (iii) not generally associated with an underlying malignant disease process. These important distinctions have allowed for successful non-surgical treatment strategies in the pediatric population. Although there remains a clear role for surgical therapy in selected children with esophageal perforations, the management paradigm has clearly shifted towards less invasive treatment modalities as the first line of therapy in children who are otherwise clinically stable.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Gander JW, Berdon WE, Cowles RA (2009) Iatrogenic esophageal perforation in children. Pediatr Surg Int 25:395–401

    Article  PubMed  Google Scholar 

  2. Engum SA, Grosfeld JL, West KW et al (1996) Improved survival in children with esophageal perforation. Arch Surg 131:604–610

    Google Scholar 

  3. Martinez L, Rivas S, Hernandez F et al (2003) Aggressive conservative treatment of esophageal perforations in children. J Pediatr Surg 38:685–689

    Google Scholar 

  4. Kim IO, Yeon KM, Kim WS et al (1993) Perforation complicating balloon dilation of esophageal strictures in infants and children. Radiology 189:741–744

    Google Scholar 

  5. Gupta NM, Kaman L (2004) Personal management of 57 consecutive patients with esophageal perforation. Am J Surg 187:58–63

    Article  PubMed  Google Scholar 

  6. Warden HD, Mucha SJ (1961) Esophageal perforation due to trauma in the newborn. A case report. Arch Surg 83:813–815

    Article  PubMed  CAS  Google Scholar 

  7. Krasna IH, Rosenfeld D, Benjamin BG et al (1987) Esophageal perforation in the neonate: an emerging problem in the newborn nursery. J Pediatr Surg 22:784–790

    Google Scholar 

  8. Mollitt DL, Schullinger JN, Santulli TV (1981) Selective management of iatrogenic esophageal perforation in the newborn. J Pediatr Surg 16:989–993

    Article  PubMed  CAS  Google Scholar 

  9. Aaronson A, Cywes S, Louw JH (1975) Spontaneous esophageal rupture in the newborn. J Pediatr Surg 10:459–466

    Article  PubMed  CAS  Google Scholar 

  10. Ajalat GM, Mulder DG (1984) Esophageal perforations. The need for an individualized approach. Arch Surg 119:1318–1320

    Article  PubMed  CAS  Google Scholar 

  11. Han SY, McElvein RB, Aldrete JS et al (1985) Perforation of the esophagus: correlation of site and cause with plain film findings. Am J Roentgenol 145:537–540

    Google Scholar 

  12. Chapdelaine J, Beaunoyer M, Daigneault P et al (2004) Spontaneous pneumomediastinum: are we overinvestigating? J Pediatr Surg 39:681–684

    Google Scholar 

  13. Swanson JO, Levine MS, Redfern RO et al (2003) Usefulness of high-density barium for detection of leaks after esophagogastrectomy, total gastrectomy, and total laryngectomy. Am J Roentgenol 181:415–420

    Google Scholar 

  14. Lynch FP, Coran AG, Cohen SR et al (1974) Traumatic esophageal pseudodiverticula in the newborn. J Pediatr Surg 9:675–681

    Google Scholar 

  15. Panieri E, Millar AJ, Rode H et al (1996) Iatrogenic esophageal perforation in children: patterns of injury, presentation, management, and outcome. J Pediatr Surg 31:890–895

    Google Scholar 

  16. Strauss C, Mal F, Perniceni T et al (2010) Computed tomography versus water-soluble contrast swallow in the detection of intrathoracic anastomotic leak complicating esophagogastrectomy (Ivor Lewis): a prospective study in 97 patients. Ann Surg 251:647–651

    Google Scholar 

  17. Brewer LA, 3rd, Carter R, Mulder GA et al (1986) Options in the management of perforations of the esophagus. Am J Surg 152:62–69

    Google Scholar 

  18. Mathewson C, Jr., Dozier WE, Hamill JP et al (1962) Clinical experiences with perforation of the esophagus. Am J Surg 104:257–266

    Google Scholar 

  19. Lyons WS, Seremetis MG, deGuzman VC et al (1978) Ruptures and perforations of the esophagus: the case for conservative supportive management. Ann Thorac Surg 25:346–350

    Google Scholar 

  20. Cameron JL, Kieffer RF, Hendrix TR et al (1979) Selective nonoperative management of contained intrathoracic esophageal disruptions. Ann Thorac Surg 27:404–408

    Google Scholar 

  21. Shaffer HA, Jr., Valenzuela G, Mittal RK (1982) Esophageal perforation. A reassessment of the criteria for choosing medical or surgical therapy. Arch Intern Med 152:757–761

    Article  Google Scholar 

  22. Broto J, Asensio M, Jorro CS et al (1999) Conservative treatment of caustic esophageal injuries in children: 20 years of experience. Pediatr Surg Int 15:323–325

    Google Scholar 

  23. Vogel SB, Rout WR, Martin TD et al (2005) Esophageal perforation in adults: aggressive, conservative treatment lowers morbidity and mortality. Ann Surg 241:1016–1021

    Google Scholar 

  24. Garey CL, Laituri CA, Kaye AJ et al (2010) Esophageal perforation in children: a review of one institution’s experience. J Surg Res 164:13–17

    Google Scholar 

  25. van der Zee DC, Festen C, Severijnen RS, et al (1988) Management of pediatric esophageal perforation. J Thorac Cardiovasc Surg 95:692–695

    Google Scholar 

  26. Wright CD, Mathisen DJ, Wain JC et al (1995) Reinforced primary repair of thoracic esophageal perforation. Ann Thorac Surg 60:245–248

    Google Scholar 

  27. Peng L, Quan X, Zongzheng J et al (2006) Videothoracoscopic drainage for esophageal perforation with mediastinitis in children. J Pediatr Surg 41:514–517

    Google Scholar 

  28. Port JL, Kent MS, Korst RJ et al (2003) Thoracic esophageal perforations: a decade of experience. Ann Thorac Surg 75:1071–1074

    Google Scholar 

  29. Eroglu A, Turkyilmaz A, Aydin Y et al (2009) Current management of esophageal perforation: 20 years experience. Dis Esophagus 22:374–380

    Google Scholar 

  30. Qadeer MA, Dumot JA, Vargo JJ et al (2007) Endoscopic clips for closing esophageal perforations: case report and pooled analysis. Gastrointest Endosc 66:605–611

    Google Scholar 

  31. Freeman RK, van Woerkom JM, Ascioti AJ (2007) Esophageal stent placement for the treatment of iatrogenic intrathoracic esophageal perforation. Ann Thorac Surg 83:2003–2007

    Article  PubMed  Google Scholar 

  32. Urschel HC, Jr., Razzuk MA, Wood RE et al (1974) Improved management of esophageal perforation: exclusion and diversion in continuity. Ann Surg 179:587–591

    Google Scholar 

  33. Hendren WH, Henderson BM (1968) Immediate esophagectomy for instrumental perforation of the thoracic esophagus. Ann Surg 168:997–1003

    Article  PubMed  CAS  Google Scholar 

  34. Orringer MB, Stirling MC (1990) Esophagectomy for esophageal disruption. Ann Thorac Surg 49:35–42

    Article  PubMed  CAS  Google Scholar 

  35. Hirschl RB, Yardeni D, Oldham K et al (2002) Gastric transposition for esophageal replacement in children: experience with 41 consecutive cases with special emphasis on esophageal atresia. Ann Surg 236:531–539

    Google Scholar 

  36. Kimberley KL, Ganesh R, Anton CK (2011) Laparoscopic repair of esophageal perforation due to Boerhaave syndrome. Surg Laparosc Endosc Percutan Tech 21:e203–e205

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shaun M. Kunisaki .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Italia

About this chapter

Cite this chapter

Kunisaki, S.M., Bruch, S.W., Coran, A.G. (2013). Esophageal Perforation. In: Lima, M. (eds) Pediatric Thoracic Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-5202-4_11

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-5202-4_11

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5201-7

  • Online ISBN: 978-88-470-5202-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics