Management of esophageal perforation: experience from a tertiary center in India.
OBJECTIVE
The management of esophageal perforations remains controversial in large part due to variability in etiology, time of presentation, location, and underlying esophageal disease. We reviewed our experience in treating patients with esophageal perforations and evaluated the etiology, management and outcome of intervention in a tertiary center.


METHODS
Between 1999 and 2007, 48 patients with esophageal perforation were treated in a tertiary referral center in southern India. Postdilatation corrosive stricture perforations constituted the major etiology.


RESULTS
Thirty (62.5%) patients were diagnosed early (<24 h) and the remaining 18 (37.5%) were late (>24 h). The 30-day mortality was 6.2%, and mean hospital stay was 13 +/- 9.3 days. Comparing outcomes between early and late groups, statistically significant difference was observed, with increased mortality (p = 0.02) and hospital stay (p = 0.04) following late diagnosis.


CONCLUSIONS
This report suggests that early diagnosis decreases mortality and hospital stay in esophageal perforation. Preservation of esophagus may be attempted while treating esophageal perforations.
Amudhan
Anbalagan
A
Institute of Surgical Gastroenterology, Centre for GI Bleed and Division of Hepato-Biliary Pancreatic Diseases, Gastroenterology Block, Government Stanley Medical College Hospital, The Tamilnadu Dr. MGR Medical University, Chennai 600001, India.
Rajendran
Shanmugasundaram
S
Raj
Vellayudham Vimal
VV
Rajarathinam
Govindhasamy
G
Jyotibasu
D
D
Ravichandran
Palanisamy
P
Jeswanth
Satyanesan
S
Balachandar
Tirupporur Govindaswamy
TG
Kannan
Devy Gounder
DG
Surendran
Rajagopal
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002985:Clinical Protocols; D004939:Esophageal Perforation / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D016629:Esophagectomy / Q000379:methods*; D004946:Esophagostomy / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007194:India / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult