JOURNAL ARTICLE
REVIEW

Esophageal perforation: surgical, endoscopic and medical management strategies

Boris Sepesi, Daniel P Raymond, Jeffrey H Peters
Current Opinion in Gastroenterology 2010, 26 (4): 379-83
20473156

PURPOSE OF REVIEW: The purpose of this article is to review current therapeutic strategies and outcomes in the management of esophageal perforation. The relative rarity and unpredictability of esophageal perforation has precluded a randomized or multiinstitutional study of this condition. Practice standards are based primarily on retrospective reviews and expert opinions.

RECENT FINDINGS: The last decade has observed a shift from an aggressive early operative intervention to a judicious, nonoperative management of esophageal perforation in selected patients. Encouraging outcomes for nonoperative management published in recent literature result from advancements in esophageal stent technology, imaging sciences, and critical care.

SUMMARY: Perforation of the esophagus, regardless of the cause, remains a major life-threatening event. Early recognition and aggressive care by a clinical team with experience in a variety of treatment modalities is increasingly important in achieving optimal outcomes in this difficult problem. Recently, encouraging results have been published utilizing esophageal stents and diligent nonoperative care in patients with esophageal perforation. The guiding principles in the treatment of this challenging condition remain early diagnosis, appropriate resuscitation, sepsis control, nutritional support, and re-establishment of esophageal continuity. Herein, we review the recent reports on the surgical, medical, and endoscopic treatment of esophageal perforation.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
20473156
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"