title: Conservative management of a case of cervical esophagus perforation with mediastinal abscess and bilateral pleural effusion.
abstract: Perforation of the cervical esophagus is a serious circumstance. Mediastinitis secondary to esophageal perforations is associated with high mortality. There is a lack of consensus on the optimal treatment for this condition. We present a case of conservative treatment in an 82-year-old woman with cervical esophagus rupture associated with mediastinal abscess and bilateral pleural effusion resulting from dilatation of a malignant esophageal stricture. Conservative treatment consisted on broad-spectrum intravenous antibiotic therapy, antireflux measures and gastrostomy was satisfactory. Treatment of the esophageal perforation should be individualized to the circumstances of each patient. Advances in antibiotic and nutritional therapy, early institution of treatment and observance of the indications, made possible a more frequent use of a conservative therapeutic approach.
authors.affiliation: Department of Otorhinolaryngology, Hospital de la Princesa, Diego de León 62, 28006, Madrid, Spain. ahinojar@hlpr.insalud.ed
authors.forename: Adolfo G
authors.initials: AG
authors.lastname: Hinojar
authors.forename: María Antonia Rodríguez
authors.initials: MA
authors.lastname: Castejón
authors.forename: Adolfo A
authors.initials: AA
authors.lastname: Hinojar
mesh_terms: D000038:Abscess / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004938:Esophageal Neoplasms / Q000150:complications*; D004939:Esophageal Perforation / Q000209:etiology / Q000628:therapy*; D005260:Female; D005774:Gastrostomy; D006801:Humans; D008477:Mediastinal Diseases / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D016066:Pleural Effusion, Malignant / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents