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Ann Thorac Surg 1982;33:203-210
© 1982 The Society of Thoracic Surgeons

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Articles

Esophageal Perforation

From the Surgical Services, Massachusetts General Hospital, and the Department of Surgery, Harvard Medical School, Boston, MA

^* Address reprint requests to Dr. Malt, Massachusetts General Hospital, Boston, MA 02114

Esophageal perforation can be caused by any instrument, device, or foreign body reaching the hypopharynx. Diagnosis remains difficult. If esophageal perforation is suspected, Gastrografin (meglucamine diatrizoate) swallow study, eventually followed by barium swallow study, is the most useful diagnostic test. Absolute rules cannot be made about the selection of nonoperative or surgical treatment. If diagnosed early, cervical or thoracic esophageal perforations can sometimes be treated conservatively if there are no signs of systemic sepsis. Recurrent leakage after surgical closure is not unusual. Local tissue flaps can reinforce the closure, particularly after delayed operation, thereby often avoiding the necessity for a reoperation or an esophageal exclusion.

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