Clinical Analysis and Treatment of Esophageal Perforation.
- Author:
Hoon PARK
1
;
Dong Yoon KEUM
;
Nam Hee PARK
;
Chang Kwon PARK
;
Kwang Sook LEE
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Keimyung University School of Medicine, Korea. kdy@dsmc.or.kr
- Publication Type:Original Article
- Keywords:
Esophageal perforation;
Risk factor
- MeSH:
Drainage;
Esophageal Perforation*;
Esophagus;
Female;
Gastric Acid;
Humans;
Male;
Mediastinitis;
Mortality;
Retrospective Studies;
Risk Factors;
Rupture, Spontaneous;
Survival Rate
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2006;39(2):111-116
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Perforation of the esophagus is a deadly injury that requires expert management for survival. The mediastinal contamination with microorganisms, gastric acid, and digestive enzymes results in a mediastinitis that is often fatal if untreated. MATERIAL AND METHOD: Between January 1990 and June 2004, 38 patients with esophageal perforation were treated in our hospital. Retrospective review of these cases has been performed. RESULT: There were 28 males and 10 females. The mean age was 43.84+/-18.89 years (range 1~73 years). Spontaneous rupture was found in 34% of perforations, iatrogenic perforation in 32% and traumatic perforation in 34%. Perforation occurred in the cervical esophagus in 8 cases, thoracic esophagus in 29 and abdominal esophagus in 1. In the cervical esophageal perforation, managements were primary closure in 8 and drainage in 2. In the thoracic esophageal perforation, managements were primary closure in 14, resection in 3 and conservative management in 12. The mortality rate was 25% in cervical esophageal perforation and 34.5% in thoracic esophageal perforation. We revealed risk factor of esophageal perforation to be peropertaive septic condition (p=0.005). CONCLUSION: Most important risk factor of esophageal perforation was preoperative septic condition. Preoperative prompt and aggressive preoperative treatment may improve the survival rate of esophageal perforation.
