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Ann Thorac Surg 1978;25:346-350
© 1978 The Society of Thoracic Surgeons

Articles

Ruptures and Perforations of the Esophagus: The Case for Conservative Supportive Management

William S. Lyons, M.D.*, Michael G. Seremetis, M.D., Vicente C. deGuzman, M.D., Joseph W. Peabody, Jr., M.D.

Georgetown University School of Medicine and the surgical services of Greater Southeast Community Hospital, Sibley Memorial Hospital, and Washington Hospital Center, Washington, DC.

* Address reprint requests to Dr. Lyons, The Atrium Building, Duke and Washington Sts, Alexandria, VA 22314

A series of 31 patients treated for ruptures and perforations of the intrathoracic esophagus is reviewed. Eighteen of these patients underwent major thoracotomy; 11 were treated with minor procedures. Two died before treatment could be implemented. Of the 18 undergoing major operations, 7 died; among the 11 managed conservatively there was only 1 death. Based on this experience, we conclude that major surgical repair for esophageal perforation is often unnecessary. It has the additional drawback of sometimes resulting in equally serious secondary procedures.




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