HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Henri L. Porte Alain J. Wurtz Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Guillem, P. G. Articles by Wurtz, A. J. Search for Related Content PubMed PubMed Citation Articles by Guillem, P. G. Articles by Wurtz, A. J.

Ann Thorac Surg 2000;69:1707-1710
© 2000 The Society of Thoracic Surgeons

---

Original articles: General thoracic

Perforation of Barrett’s ulcer: a challenge in esophageal surgery

^a Service de Chirurgie Digestive et Générale, CAO, CAEB, Hôpital Huriez, France
^b Service de Chirurgie Thoracique, Hôpital Calmette, CHetU Lille, Lille, France

Address reprint requests to Dr Porte, Service de Chirurgie Thoracique, Hôpital Calmette, CHetU Lille, 59037 Lille, France
e-mail: awurtz{at}chru-lille.fr

Background. Barrett’s ulcer, which develops within Barrett’s esophagus, is frequently responsible for bleeding. Perforation is a rare complication constituting a great challenge for diagnosis and management.

Methods. Three personal cases and 31 published reports of perforated Barrett’s ulcer were reviewed retrospectively. The site of perforation, clinical presentation, management, and outcome were assessed.

Results. The clinical presentation proved to be heterogeneous and was determined by the site of perforation: this was the pleural cavity (20% of cases), mediastinum (20%), left atrium (16.6%), tracheobronchial tract (13.3%), aorta (13.3%), pericardium (10%), or pulmonary vein (6.6%). Early esophagectomy and esophageal diversion-exclusion were the most frequent procedures, and overall mortality was 45%.

Conclusions. The poor prognosis of perforated Barrett’s ulcer should be improved by earlier diagnosis and adequate emergent operation. Although early esophagectomy constitutes the recommended procedure, esophageal diversion-exclusion, which allows control of both sepsis and bleeding, is also of interest.

This article has been cited by other articles:

				J. J. Nigro, R. M. Bremner, C. B. Fuller, J. Theisen, Y. Ma, and V. A. Starnes Perforating Barrett's ulcer resulting in a life-threatening esophagobronchial fistula Ann. Thorac. Surg., January 1, 2002; 73(1): 302 - 304. [Abstract] [Full Text] [PDF]