Surgical Management of Esophageal Perforation due to Fish Bone: A Report of Four Cases

생선뼈'에 의한 식도천공의 외과적 치료: 4례 보고

This is a report on a total of four cases of esophageal perforation due to fish bone in the Department of Thoracic Surgery, Hanyang University Hospital. The perforated portions of esophagus were upper third of esophagus, that is, cervical esophalgus principally. The complications after esophageal perforation were acute mediastinitis with mediastinal emphysema in 2 cases, acute mediastinitis with both pyothorax in one case and cervical subcutaneous abscess alone in one case. Collar mediastinostomy was required to control disturbance of cardiopulmonary function as emergency procedure. Gastrostomy was of worthy for the various purposes, that` is, for feeding, absolute rest of the esophagus, and for prevention against continuous infection from esophageal leakage. After the gastrostomy. 3 cases were healed by spontaneous closure of esophageal perforation between one to four weeks. One case expired from severe septic shock due to acute diffuse mediastinitis and both pyothorax.