Outcomes after oesophageal perforation: a retrospective cohort study of patients with different aetiologies

Law, TT; Chan, Jonathan Yl; Chan, Desmond Kk; Tong, Daniel; Wong, Ian Yh; Chan, Fion Sy; Law, Simon

doi:10.12809/hkmj164942

Cited by 9 publications

(15 citation statements)

References 29 publications

(45 reference statements)

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“…Algunos cirujanos hacen el cierre solo si el paciente consulta en las primeras 24 horas de haber ocurrido la perforación y otros intentan el cierre independientemente del tiempo transcurrido. El tratamiento endoscópico con la colocación de stent, está ganando espacio, con aparente alta tasa de éxito en pacientes seleccionados 8 . La cirugía es importante en el manejo de la PEE.…”

Section: Discussionunclassified

“…El tratamiento de la PEE depende de varios factores, como la etiología, sitio de la perforación, tiempo transcurrido desde la perforación hasta el diagnóstico, el grado de la contaminación del peritoneo o mediastino, comorbilidades, y estado general del paciente 7 . Para un tratamiento exitoso son importantes las primeras 24 horas 8 . Se puede realizar un manejo no quirúrgico, cuando no presenta signos de infección o de sepsis, perforación reciente, espacio pleural no contaminado, sin perforación abdominal, perforación bien circunscrita, sin malignidad, obstrucción o estenosis en el lugar de la perforación.…”

Section: Introductionunclassified

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Perforación esofágica espontánea

Díaz

Carías

2021

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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Section: Discussionunclassified

Section: Introductionunclassified

Perforación esofágica espontánea

Díaz

Carías

2021

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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“…Considering the surgical team experience, the initial esophagectomy may be considered a valid procedure. The prevalence of high mortality in our series was mainly due to delayed presentation of symptoms and, subsequently, delayed diagnosis [22,23].…”

Section: Discussionmentioning

confidence: 99%

Boerhaave's syndrome with late presentation. Experience in an Argentine single center: Case series

Hernández

Horiuchi

Rivaletto

et al. 2019

Annals of Medicine and Surgery

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Background In the year 1724, Hermann Boerhaave reported a case of a Dutch admiral who died due to spontaneous rupture of the esophagus following vomiting. The aim of this retrospective study is to analyze the therapeutic modality, morbidity and mortaliy of a group of patients with spontaneous esophageal rupture treated in our hospital. Methods Ten patients were treated from March 1990 to August 2016. Seven patients were males and three were females. The age range was, 52–72 years, with an average of 66.2 years. In four patients, the diagnosis and posterior treatment were performed within 24 h (Group I) and the remaining six patients after 24 h (Group II). Results The mean hospital stay was 36.6 days (range 17–62 days). The mortality rate was 50%, which was due to septic shock and the morbidity of patients who survived was 40% due to pneumonia in one case and fistula in another. Discussions This condition has a high mortality rate with a lethality that depends on the time between recognition of symptoms and proper surgical treatment.

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“…Large circumferential perforations, non-dilatable strictures, early stage malignancy and end stage benign disease represent indications for resection and reconstruction (27,28,47). Oesophagectomy has also been used where primary repair or stenting have failed to control sepsis (1,9).…”

Section: Surgical Treatmentmentioning

confidence: 99%

Iatrogenic oesophageal perforation

Rozwadowski¹,

Internullo²

2021

Shanghai Chest

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Oesophageal perforation can be a devastating injury, associated with high morbidity and mortality. Known causes include iatrogenic, spontaneous, traumatic and foreign bodies. Iatrogenic perforations remain the most common. Early diagnosis is vital but difficult, as symptoms are often nonspecific and sometimes relatively mild. Therefore, a high index of suspicion is important, especially after any oesophageal instrumentation or intra-thoracic surgery. The presentation of oesophageal perforation can vary significantly. Timing of diagnosis, presence of systemic symptoms, underlying oesophageal pathology, site and size of perforation influence management. In the lack of evidence, management options vary and there is not one recognized optimum treatment strategy, however there is consensus that oesophageal perforations managed within 24 hours have significantly better outcomes. Historically, the mainstay of treatment has been surgical, with methods including drainage and primary repair, exclusion and diversion techniques, and oesophagectomy. In carefully selected patients with a prompt diagnosis and no systemic symptoms a conservative approach has been successful. This includes fluid resuscitation, intravenous antimicrobials, nothing-by-mouth, gastric decompression and parenteral nutrition. Endoscopic clipping, suturing or stenting have gained popularity in the last couple of decades and are now established approaches in selected patients, as an alternative or in combination with surgery. Novel treatments include the use of endoscopic vacuumassisted therapy (EVT). This review outlines the current approach to iatrogenic oesophageal perforation.

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Outcomes after oesophageal perforation: a retrospective cohort study of patients with different aetiologies

Cited by 9 publications

References 29 publications

Perforación esofágica espontánea

Perforación esofágica espontánea

Boerhaave's syndrome with late presentation. Experience in an Argentine single center: Case series

Iatrogenic oesophageal perforation

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