Pearls and Pitfalls
Esophageal perforation is a rare but hazardous event.
Iatrogenic damage during upper gastrointestinal endoscopy accounts for the majority of injuries.
Therapeutic endoscopy carries a 200-fold higher perforation risk than diagnostic endoscopy.
Clinical features depend on the cause, site and time of injury.
Severe, sudden chest pain after vomiting associated with subcutaneous emphysema is pathognomic of spontaneous perforation of the esophagus.
Survival is dependent on rapid control of mediastinal and pleural contamination.
Surgery is mandatory when gross contamination is present, when there is tissue loss or in perforations associated with caustic injuries.
Thorough wound debridement, lavage of pleural and mediastinal cavities and drainage are probably more important than any specific repair technique employed in cases where surgery is performed.
Introduction
Esophageal perforation is a rare event, which can occur through a variety of insults and carries a high...
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Griffin, S.M., Shenfine, J. (2009). Esophageal Perforation. In: Bland, K.I., Büchler, M.W., Csendes, A., Sarr, M.G., Garden, O.J., Wong, J. (eds) General Surgery. Springer, London. https://doi.org/10.1007/978-1-84628-833-3_42
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