title: Successful late management of esophageal perforation with T-tube drainage.
abstract: The late management of spontaneous esophageal perforation is the most challenging problem for the surgeon. In this paper, we present a case in whom a spontaneous esophageal perforation was successfully treated by T-tube drainage after unsuccessful conservative treatment. The patient, a 68-year-old male, was admitted to the hospital with sudden upper abdominal pain. After 2 days, esophageal perforation was diagnosed, and conservative management was begun. Thereafter, the subcutaneous emphysema disappeared, and the patient's temperature decreased. However, on day 13, the patient's temperature spiked above 38°C, and computed tomography showed a mediastinal abscess. An emergency left thoracotomy with laparotomy was performed. Since a 2-cm longitudinal perforation with severe inflammatory reactions was observed, the T-tube drainage method was performed. The patient was discharged without postoperative complications and has not experienced any gastrointestinal symptoms, such as gastroesophageal reflux or dysphagia. In conclusion, the T-tube drainage method appears to be a simple and effective method for the late management of esophageal perforation with severe inflammatory reaction.
authors.affiliation: Department of Surgery, Gunma Prefectural Cardiovascular Center, Maebashi, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nakabayashi
authors.forename: Michiaki
authors.initials: M
authors.lastname: Kudo
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hirasawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano