title: Conservative approach to the mediastinitis in childhood secondary to esophageal perforation.
abstract: The aim of this study was to evaluate the safety and efficacy of nonoperative treatment of esophageal perforation (EP) in children. Between 1999 and 2004, 13 episodes in 12 patients were evaluated. The treatment program consisted of broad-spectrum antibiotics, nasopharyngeal aspiration, parenteral and/or enteral nutrition by gastrostomy, and pleural effusion or mediastinal abscess drainage when required. Mean age of the patients was 3.75 +/- 1.13 (range 3-7 years). Two patients (16.7%) were girls and 10 patients (83.3%) were boys. Chest pain was found 76.9% of all EP episodes (10 of 13 perforations), followed by dyspnea in 69.2% (9 of 13), vomiting in 46.1% (6 of 13), fever in 46.1% (6 of 13), and epigastric pain in 7.6% (1 of 13). No deaths occurred. In children, in contrast with the adults, EP can be treated safely by nonoperative methods.
authors.affiliation: Department of Pediatric Surgery, Gulhane Military Medical Academy, Ankara, Turkey.
authors.forename: Suzi
authors.initials: S
authors.lastname: Demirbag
authors.forename: Tugrul
authors.initials: T
authors.lastname: Tiryaki
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Atabek
authors.forename: Ilhami
authors.initials: I
authors.lastname: Surer
authors.forename: Haluk
authors.initials: H
authors.lastname: Ozturk
authors.forename: Salih
authors.initials: S
authors.lastname: Cetinkursun
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004939:Esophageal Perforation / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D018529:Nutritional Support; D011859:Radiography; D012189:Retrospective Studies; D013396:Suction; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents