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. 2003 Feb;96(2):158-63.
doi: 10.1097/01.SMJ.0000054566.43066.B5.

Thoracic esophageal perforations

Paul D Kiernan  1 , Michael J Sheridan, Eric Elster, John Rhee, Lucas Collazo, William D Byrne, Thomas Fulcher, Vivian Hettrick, Betty Vaughan, Paula Graling
Affiliations

Thoracic esophageal perforations

Paul D Kiernan et al. South Med J. 2003 Feb.

Abstract

Background: Recognition of the importance of early diagnosis and aggressive, definitive surgical intervention has brought about a dramatic decline in mortality related to distal esophageal perforation.

Methods: We retrospectively analyzed all cases of thoracic esophageal perforation diagnosed at our hospital from September 1, 1979, through April 1, 2001. The study group consisted of 62 patients (43 men) with a mean age of 58.8 years (range, 20-92 yr).

Results: In the group of 39 patients with early diagnosis (< or = 24 h), hospital survival was 87%, which increased to 93% when early diagnosis was combined with aggressive surgical treatment Among the 23 patients with late diagnosis (> 24 h), survival approached 70%. Yet, in patients who were treated aggressively with surgery, survival was almost 90% despite delayed diagnosis.

Conclusion: We recommend aggressive, definitive surgery for thoracic esophageal perforations, whether diagnosed early or late. A variety of options are discussed with regard to complicated presentations.

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