Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ESOPHAGEAL PERFORATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources
PubMed2005

Treatment of esophageal perforation in a referral center in taiwan.

PURPOSE: The high mortality associated with esophageal perforation can be reduced by aggressive surgery and good critical care. We report our experience of treating esophageal perforation in a clinic in Taiwan. METHODS: The subjects were 28 patients who underwent surgery for a benign esophageal perforation. RESULTS: The esophageal perforation was iatrogenic in 11 patients, spontaneous in 8, and caused by foreign body injury in 9. Most (22/28) of the patients were seen longer than 24 h after perforation, and 77% had empyema preoperatively. The perforation was located in the cervical area in 5 patients and in the thoracic esophagus in 23. We performed primary repair in 24 patients, esophagectomy in 3, and drainage in 1. Leakage occurred after primary repair in ten (41%) patients, resulting in one death, and two patients died of other diseases. Postoperative leakage prolonged the hospital stay but had no impact on mortality. Overall survival was 90%. Univariate analysis revealed that age, timing of treatment, and cause and location of the perforation influenced outcome, but multivariate analysis failed to identify a predictor of mortality. CONCLUSIONS: Early diagnosis and intervention are crucial to prevent morbidity and mortality in patients with esophageal perforation. Primary repair is feasible even if the diagnosis is delayed.

Adult↗
PubMedDate not supplied

The diagnosis of unsuspected esophageal perforation by computed tomography.

The successful management of esophageal perforation requires prompt diagnosis and surgical intervention. The hazards of delayed recognition of esophageal perforation have been recently emphasized. A case of unsuspected esophageal perforation detected by computerized tomography of the chest (CT) is described and illustrated. CT is an effective technique for displaying mediastinal and complex pleural-parenchymal abnormalities and often provides information which is of diagnostic value.

Carcinoma, Squamous Cell↗
PubMed2005

Surgical treatment of traumatic esophageal perforations: analysis of 10 cases.

PURPOSE: Traumatic esophageal perforations are infrequent. They represent a surgical dilemma for surgeons, especially if diagnosis is made late. Recently, it has been reported that mortality due to perforation of the esophagus has diminished independently of time of presentation. The experience with traumatic perforations of the esophagus is reviewed to determine morbidity-mortality and how it is affected by time. METHODS: A retrospective clinical review was made of all patients with a diagnosis of traumatic perforation of the esophagus treated by the author. There were 10 patients, all of them male. Average age was 32 years (range 17 to 63). The cause of trauma was gunshot (7), blunt trauma (1) and foreign body (2). Four patients were treated within 24 hours of injury (early treatment). Treatment of 6 patients was delayed 56 to 168 hours after the injury (delayed treatment). RESULTS: Patients treated early underwent primary repair. Delayed treatment included: primary repair (1), T-tube (2), drainage of cervical abscess and pulmonary decortication (2), and conservative treatment (1). There was 1 death in the delayed group (16.6%). One patient in the early treatment group (25%); 4 (66%) in the delayed treatment group had complications. Postoperative stay in the hospital was an average of 20.5 days for the early treatment group and 38 for the late treatment group. CONCLUSIONS: Mortality of traumatic esophageal perforations has diminished significantly. Morbidity, particularly in delayed treatment, is still very high, with multiple operations and prolonged stays in intensive care units and surgical wards, resulting in high hospital costs. The main factor that seems to influence mortality-morbidity of traumatic esophageal perforations is the time of diagnosis. Every effort should be made to diagnose these injuries early. Once diagnosis is made, treatment should be aggressive and expeditious.

Adolescent↗
PubMed2004

Esophageal perforation during laparoscopic gastric band placement.

Esophageal perforation is a serious complication that requires prompt recognition and treatment. We present the case of a patient with lower esophageal perforation that apparently resulted from orogastric calibration-tube passage during laparoscopic placement of a gastric band. The complication was diagnosed early postoperatively, and was able to be successfully treated by laparoscopy,debanding, drainage, and parenteral nutrition.

Aged↗
PubMed1996

Pediatric cervical esophageal perforation secondary to abusive blunt thoracic trauma.

Cervical esophageal perforation secondary to blunt trauma is extremely rare. A case of an 8-week-old infant that sustained a cervical esophageal perforation from abusive acceleration/deceleration blunt trauma is presented. Early diagnosis and appropriate intervention of an already insidious injury can be further delayed by the lack of concise temporal events and falsification of data from the abusive caretaker(s). In-depth history taking, documentation and notification of authorities lays the critical medicolegal groundwork for this unfortunately increasing problem in our society. Diagnosis and management are discussed. The pediatrician, emergency department, nursing staff and otolaryngologist should have strong suspicions of abuse when esophageal perforation is identified in an infant.

Child Abuse↗
PubMed2001

Management of esophageal perforation.

Despite recent advances in thoracic surgery, the management of esophageal perforation remains problematical and controversial. Thirty-one patients were treated for an esophageal perforation between 1986 and 1998. The esophageal perforation was iatrogenic in 25 cases, spontaneous in 2, traumatic in 2, and caused by a tumor and tuberculous lymphadenitis in 2 patients. There were 10 cervical, 19 thoracic, and 2 abdominal perforations. The interval from perforation to operation was less than 24h in 12 patients and more than 24h in 19 patients. The surgical procedures included a primary repair in 12 patients, a resection in 8, and conservative treatment with minor surgical approaches in 11. The mortality rate was 20% (4/20 patients) in the surgical treatment group and 45.5% (5/11 patients) in the conservative treatment with minor surgery group. The overall mortality was 29% (9/31 patients). The prognosis is thus concluded to depend on the cause and location of the perforation, the presence of underlying esophageal diseases, and the surgical procedure chosen.

Adolescent↗
PubMed1996

Delayed primary repair of intrathoracic esophageal perforation: is it safe?

The management of intrathoracic esophageal perforation with delayed diagnosis is a subject of controversy. Because of the obvious advantages of primary repair as a simple single-stage operation, this technique was preferentially used to treat 18 of 22 consecutive patients with esophageal perforation. These patients were stratified into three groups according to the time interval between perforation and repair: group A, less than 6 hours, five patients (28%); group B, 6 to 24 hours, six patients (33%); and group C, more than 24 hours, seven patients (39%). Group A patients were older (p < 0.05) and group B had fewer iatrogenic perforations (B, 17%; A, 80%; C, 57%, p < 0.1). Additional tissue was used to buttress the repair site in all three groups (A, 3/5 patients, 60%; B, 4/6 patients, 67%; C, 6/7 patients, 86%; p = not significant). In seven patients (39%), a fundic wrap was used to reinforce the site of primary repair. The outcomes of the three groups were analyzed. Group A had the lowest proportion of postoperative leaks (A, 0/4 patients, 0%; B, 4/6 patients, 67%; C, 5/6 patients, 83%; p < 0.05) and postoperative morbidity (A, 2/5 patients, 40%; B, 6/6 patients, 100%; C, 6/7 patients, 86%; p < 0.1). However the increased incidence of leak and morbidity did not lead to an increase in mortality. One death occurred in each group, with an overall mortality of 17% (A, 1/5 patients, 20%; B, 1/6 patients, 17%; C, 1/7 patients, 14%; p = not significant). We conclude that in the era of advanced intensive care capabilities, primary repair of intrathoracic esophageal perforation can be safely accomplished in most patients regardless of the time interval between perforation and operation. Leakage at the suture site is common unless primary repair is carried out without delay. Postoperative leakage, however, is usually inconsequential and does not necessarily result in an adverse outcome.

Aged↗
PubMed1979

Acute esophageal perforation in an adolescent burn patient.

Acute esophageal perforation in a 15-year-old male who sustained 40% body burns in a gasoline explosion is reported. He experienced an acute esophageal perforation from gastric distention and esophageal reflux during initial transit to the Cincinnati Shriners Burns Institute on the second postburn day. Bilateral hydropneumothorax occurred and the patient soon expired without treatment. Prevention of this complication is best achieved by placement of a nasogastric tube and aggressive antacid therapy.

Acute Disease↗
PubMedDate not supplied

Surgical treatment of esophageal perforation.

BACKGROUND/AIMS: In spite of the progress made during the last few decades, esophageal perforation continues to carry a serious prognosis. The aim of this study is to present our experience with surgical treatment of esophageal perforation. METHODOLOGY: Eight patients with esophageal perforation were submitted to surgical treatment with varying time intervals between the perforation and the operation. The surgical technique was individualized according to the location of the perforation and the severity of the local inflammatory and necrotic findings. Follow-up data was obtained by follow-up examination or telephone contact with the family doctors. The medical records were reviewed. The cause, the location and the clinical manifestations of perforation, the underlying esophageal disease, the imaging techniques and other examinations which were used to establish diagnosis, the time interval between the perforation and the operation, the surgical techniques, the outcome, the complications, the duration of postoperative hospitalization, and the late results were analyzed. RESULTS: The perforation was due to iatrogenic injury in 6 of 8 patients. Underlying esophageal disease was present in 4 patients. The mean time interval between the perforation and the operation was 4.3 days. Primary repair was attempted in 5 patients, exclusion-diversion of the esophagus in 2 and thorough drainage in 1 patient. There was no mortality. Primary closure was achieved in 80% of the patients in whom primary repair was attempted. Seven out of 8 patients were alive 46-150 (mean, 99.12) months after the operation. CONCLUSIONS: Surgery is the treatment of choice for patients with esophageal perforation including those seen more than 24 hours after the onset of symptoms. The chosen surgical technique depends on the location of perforation and the severity of local inflammatory and necrotic findings.

Adolescent↗
PubMed1980

Esophageal perforation following use of the esophageal obturator airway.

Four cases of esophageal rupture associated with the use of the esophageal obturator airway are presented and added to the fifteen cases already in the literature. The incidence of this complication may be greater than previously suspected since a systematic search for this complication has not been made in cardiac arrest patients. The mechanism of rupture of the occluded esophagus may be similar to that seen in postemetic rupture. Endotracheal intubation remains the procedure of choice in airway control of cardiac arrest patients, although the modified esophageal obturator airway with gastric tube may prevent the occurrence of esophageal rupture by allowing decompression of the esophagus.

Aged↗
PubMed1994

A spontaneous esophageal perforation and duodenal ulcer perforation resulting in a subpulmonic abscess.

Both spontaneous esophageal perforations (Boerhaave syndrome) and duodenal ulcer perforations are medical emergencies. Spontaneous esophageal perforation (SEP) is the most serious and rapidly lethal perforation of the gastrointestinal tract. Prompt diagnosis and early therapy is needed to prevent death and prolonged serious illness, and the key to the diagnosis is an awareness of its frequent atypical presentations. This article presents a case report of SEP and duodenal ulcer perforation which caused a right-sided subpulmonic abscess and reviews the literature pertaining to this subject.

Adult↗
PubMed2000

Repair of esophageal perforation after treatment for achalasia.

Esophageal perforation after treatment for achalasia is a devastating complication. Successful closure of the perforation and relief of the obstruction from achalasia are paramount. This can be accomplished by careful closure of the mucosa. The mucosal closure is buttressed by a pedicled intercostal muscle carefully sewn to the edges of the muscular defect. This approach deals effectively with the perforation and maintains the myotomy for relief of esophageal obstruction from achalasia.

Aged↗
PubMedDate not supplied

[Esophageal perforation].

OBJECTIVE: We describe our experience in the management of esophageal perforation. MATERIAL AND METHODS: Retrolective study of the esophageal perforation patients, managed from January 1999 to December 2003. Analyzed variables were age, sex, aetiology, time of diagnosis and treatment, as well as ancillary methods employed, mode of treatment and morbidity and mortality. RESULTS: We found 13 patients: eight males (61.54%) and five females (38.46%), with an average age of 36.07 years with standard deviation of 19.77. Penetrating trauma was the leading cause in six cases, continued by iatrogenic perforation in four, Boerhaave's syndrome in one, foreign body in one, and blunt abdominal trauma in one. The principal symptom was pain in 84.61% of the cases. The esophagogram confirmed diagnosis in six cases (46.15%). The diagnosis was accomplished early in eight patients (61.54%) and late in five patients (38.46%). Nonsurgical treatment was carried out in two cases (15.38%) and surgical in 11 patients (84.62%). The average hospital stay was 22.45 days. Mortality in general was 15.38%, 0% for those with an early diagnosis and management and 40% for those delayed. CONCLUSIONS: An early diagnosis of esophageal perforation with the appropriate management (surgical or nonsurgical) will considerably diminish patient morbidity and mortality. A treatment choice could not be defined for the early or late diagnosis, but if surgical treatment is undertaken, adequate drainage for the perforation should be instituted as one of its principles.

Adult↗
PubMed2004

Esophageal perforation of aortic arch aneurysm treated free of mediastinitis without manipulating esophagus.

Esophageal perforations of thoracic aortic aneurysms are most likely to be fatal. Patients with aortoesophageal fistula require urgent operation on both the esophageal perforation site and the aortic lesion to avoid terminal exsanguination and uncontrollable mediastinitis. We present a case of 71-year-old woman suffering esophageal perforation of aortic arch aneurysm with sentinel arterial hemorrhage, who has not developed patent aortoesophageal fistula. Computed tomography verified rupture of aortic arch aneurysm that had eroded the esophagus. She underwent successful graft replacement and remains well without signs of mediastinitis over one year after the event. It is possible, in selected cases of esophageal perforation of thoracic aortic aneurysm, to manage the esophageal lesion without any surgical intervention, such as primary closure, omental coverage and surgical discontinuity to achieve esophageal healing free of infection.

Aged↗
PubMed2003

Esophageal perforation after tracheal intubation, spontaneous or iatrogenic?--a case report.

Esophageal perforation is a rare but life-threatening complication associated with tracheal intubation, especially after difficult intubation. Esophageal perforation after anesthesia is rare and usually secondary to esophageal instrumentation. Spontaneous esophageal perforation following forceful vomiting (Boerhaave's syndrome) is also extremely rare and has some risk factors. We present a case of perforation of esophagus after cataract surgery under general anesthesia with gentle orotracheal intubation and discuss the possible mechanisms responsible for this unusual disease entity. The patient underwent successful surgical repair and was still alive 4 years after the operation.

Aged↗