Response to Multimodal Treatment Strategies for Esophageal Perforation

Horvath, Philipp; Lange, Jessica; Stüker, D; Wichmann, Dörte; Hilbert, Julia; Götz, Martín; Königsrainer, Alfred; Feilitzsch, M von; Zdichavsky, Marty

doi:10.1097/sle.0000000000000701

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2020

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“…Treatment options for oesophageal perforation due to foreign body depend on the patient’s clinical condition at presentation, PSS score and availability of the expertise. 2,3,5,10 The contained perforation with a low or intermediate PSS score can be managed with antibiotics and nutritional support, while those with a non-contained perforation and intermediate PSS score can be managed with a damage control procedure. This involves initial aggressive mediastinal drainage, tube thoracostomy for empyema, injectable antibiotics and nutritional support.…”

Section: Discussionmentioning

confidence: 99%

Foreign body-related oesophageal perforation: a case series at a community-based hospital in Nepal

et al. 2020

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Oesophageal perforation is rare, associated with diagnostic dilemma, delayed presentation and high mortality rate (36%). Early diagnosis and treatment are crucial for a good outcome. Treatment is by non-operative methods (antibiotics, drainage of collections, oesophageal stenting and nutritional support) or by surgery, depending on the condition of the patient, timing of presentation and expertise. During a five-year period (2015–2019), we managed seven cases of oesophageal perforation due to a foreign body. Of them, 4 (57%) received operative intervention, while 3 (43%) were managed non-operatively. One postoperative mortality ensued; there was a mean hospital stay of 20 days.

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