Conservative Management of Esophageal Perforation; Clinical analysis of 14 cases

식도 천공의 보존적 치료 - 임상적 고찰 14례

  • Published : 1993.08.01

Abstract

Twenty-five patients with perforation of esophagus were managed at Pusan National University Hospital, from 1981 to 1993. The hospital course of 14 of these patients was evaluated with a special emphasis on the cause and location of perforation, clinical presentation, time elapsed from perforation to treatment, method of treatment, and outcome. Patients with anastomotic leak and cancer were excluded.The perforation was iatrogenic in 7 patients, spontaneous in 5, ingestion of foreign body in 1, and traumatic in 1. There were 7 cervical perforations, 2 upper thoracic perforations, and 5 lower thoracic perforations. Chest pain, fever, and dyspnea were frequent symptoms. Esophagography was most diagnostic [11 patients] but thoracentesis was of little diagnostic aid.Antibiotics were administered intravenously to all patients:hyperalimentation was accomplished intravenously in 11, and nasogastric suction was used in all cases. No patient required any surgical procedure, minor or major.

Keywords

References

  1. Glenn's thoracic and cardiovascular surgery, 5th ed. Esophageal perforations Witte,J.;Pratschke,E.;Baue,A.E.(eds.);Geha,A.S.(eds.);Hammond,G.L.(eds.);Laks,H.(eds.);Naunheim,K.S.(eds.)
  2. Medici v.60 Atrocis, nec descipti prius, mordihistoria secundem artis leges conscripta, lugduni hatavorum, bontes teniana Boerfaave,H.
  3. Br J Surg v.35 Report of acase of a spontaneous perforation of the esophagus successfully treated by operation Barrett,N.R.
  4. Ann Thorac Surg v.53 Esophageal perforation: A continuing challenge William,G.J.;Robert,J.G.
  5. Ann Thorac Surg v.42 Diagnosis and recommended management of esophageal perforation and rupture Bladergroen,M.R.;Lowe,J.E.;Postlethwait,R.W.
  6. AJR v.99 Spontaneous rupture of the esophagus O'Connell,N.D.
  7. Ann Thorac Surg v.47 Spontaneous rupture of the esophagus: a 30-year experience Pate,J.W.;Walker,W.A.;Cole,F.H.Jr.;Owen,E.W.;Johnson,W.H.
  8. Chest v.98 Computed tomography in patient with esophageal perforation Backer,C.L.;Locicero,J.Ⅲ;Hartz,R.S.;Donaldson,J.S.;Shields,T.
  9. Radiology v.130 Desirability of roentgen esophageal examination immediately after pneumatic dilatation for achalasia Stewart,E.T.;Miller,W.N.;Hogan,W.J.;Dodds,W.J.
  10. Am J Surg v.152 Options in the management of perforations of the esophagus Brewer,L.A.;Carter,R.;Mulder,G.A.;Stiles,Q.R.
  11. Am J Surg v.149 Unifying concepts in the treatment of esophageal leaks Richardson,J.D.;Martin,L.F.;Borzotta,A.P.;Polk,H.C.
  12. Am J Surg v.105 Rupture of the esophagus Sealy,W.C.
  13. Am J Surg v.128 Perforation of the esophagus Rosoff,L.;White,E.H.
  14. 대흉외지 v.21 의인성 흉부식도천공시 식도내 흡인, 흉강배농 및 위루관을 통한 영향공그에 의한 보존적 치료 최종범;송인기;최순호
  15. Ann Thorac Surg v.27 Selective nonoperative management of contained intrathoracic esophageal disruptions Cameron,J.L.;Kieffer,R.F.;Hendrix,T.R.;Mehigan,D.G.;Baker,R.R.
  16. J Peddiatr Surg v.16 Selective management of idtrogenic esophageal perforation in the newborn Mollitt,D.L.;Schulinger,J.N.;Santulli,T.V.
  17. JAMA v.240 Selective management of spontaneous esophageal perforation Brown,R.H.;Cohen,P.S.
  18. Ann Thorac Surg v.25 Ruptures and perfotations of the esophagus: the case for conservative supportive management Lyons,W.S.;Seremetis,M.G.;deGuzman,V.C.;Peabody,J.W.Jr.
  19. Dis Sci v.34 Nonsurgical management of esophageal perforation from pneumatic dilatation in achalasia Sewdlund,A.;Traube,M.;Siskind,B.N.;McCallum,R.W.
  20. Radiology v.170 Role of interventional radiology in the management of esophageal leaks Maroney,T.P.;Ruiz,E.J.;Gordon,R.L.;Pelligrini,C.A.