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The Annals of Thoracic Surgery, Vol 53, 534-543, Copyright © 1992 by The Society of Thoracic Surgeons
WG Jones 2d and RJ Ginsberg
Perforation of the esophagus remains a diagnostic and therapeutic
challenge. Currently, the most common cause of perforation is
instrumentation of the esophagus, and the incidence of esophageal
perforations has increased as the use of endoscopic procedures has become
more frequent. Diagnosis depends on a high degree of suspicion and
recognition of clinical features, and is confirmed by contrast
esophagography or endoscopy. Outcome after esophageal perforation is
dependent on the cause and location of the injury, the presence of
underlying esophageal disease, and the interval between injury and
initiation of treatment. Reinforced primary repair of the perforation is
the most frequently employed and preferable approach to the surgical
management of esophageal perforations. Nonoperative management consisting
of antibiotics and parenteral nutrition is particularly successful for
limited esophageal injuries meeting proper selection criteria.
ARTICLES
Esophageal perforation: a continuing challenge
Division of Thoracic Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021.
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