[Treatment of oesophageal perforations].
BACKGROUND
Esophageal perforation is a serious condition with a high mortality. Treatment is both surgical and conservative.


METHODS
Records were retrospectively reviewed for 22 patients (17 men), with median age 64 (30-85) years, that had been treated for esophageal perforation at Ullevaal University Hospital in the period 2000-2006.


RESULTS
Perforation was cervical in two (9%) patients, thoracic in 19 (86%) and abdominal in 1 (5%) of the patient(s). The etiology was iatrogenic in 11 (50%) patients, emetic in 8 (36%) and caused by a foreign body in 3 (14%) patients. Five patients with an iatrogenic etiology had oesophageal cancer. Diagnosis after onset of symptoms was evident within 24 hours in 41% patients, during 24-72 hours in 14% and later than 72 hours in 45% of the patients. Half of the patients (11) were treated surgically, including two that had been initially treated conservatively. Five patients (23%) died of thoracic perforations during hospitalization and there were no other deaths. Median hospital stay was 54 (3-174) days. At the end of follow-up median survival was 113 (12-660) days and 10 of the 22 patients were dead (45%).


CONCLUSIONS
Our impression is that early surgery of oesophageal perforation in fit patients can improve the outcome.
Gondal
Ghous
G
Gastrokirurgisk avdeling, Ullevål universitetssykehus, 0407 Oslo. ghgo@ulleval.no
Johnson
Egil
E
Johannessen
Hans-Olaf
HO
Hofstad
Bjørn
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004939:Esophageal Perforation / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome