Aetiology, Clinical Manifestations, Diagnosis, and Treatment of Oesophageal Perforation: A Review

Abstract

Oesophageal perforation (OP) is a life-threatening condition and refers to a tear or disruption in the oesophageal wall. It is considered a medical emergency due to its significant implications, often related to its various causes, such as iatrogenic perforation during endoscopy, Boerhaave syndrome, traumatic injury, foreign body ingestion, and tumour perforation. Early interventions, diagnosis, and a thorough physical examination are essential for better clinical outcomes. Diagnostic procedures and imaging techniques, play a crucial role in confirming OP. The diagnostic workup, based on the index of suspicion, may involve barium oesophagram or contrast-enhanced CT. Once diagnosed, classification of severity using the Pittsburgh clinical severity score guides treatment decisions. Management can be non-surgical or surgical and focuses on a multi-disciplinary approach combining conservative, surgical, or endoscopic methods. Surgical control remains crucial, with the approach dependent on the location of the leak. Improved knowledge of this life-threatening condition is important among healthcare professionals. The objective of this review is to provide information about oesophageal perforation and its early detection, management, and multidisciplinary interventions for optimal patient outcomes.