title: Oesophageal perforation: a diagnostic and therapeutic challenge in a resource limited setting. A report of three cases.
abstract: BACKGROUND
  Oesophageal perforation is a condition associated with a high mortality. Its management is still controversial with operative treatment being favoured but a shift to conservative management is occurring. Very little exists in medical literature about its management in Sub-Saharan Africa, where the paucity of thoracic surgeons is compounded by limited diagnostic and therapeutic facilities.
  
  
  METHODS
  We report three cases of oesophageal perforation which were all treated conservatively with tube thoracostomy, nil by mouth with feeding gastrostomy, intravenous antibiotics and chest physiotherapy. Two patients achieved oesophageal healing but one died due to severe septicaemia.
  
  
  CONCLUSIONS
  In a resource restricted setting, conservative management which includes enteral nutrition by feeding gastrostomy, tube thoracostomy to drain inter pleural contaminants, intravenous antibiotics and chest physiotherapy is a safe and effective treatment for oesophageal perforations.
authors.affiliation: Department of Cardiothoracic Surgery, Weill-Bugando University College of Health Sciences, P.O. Box 1464, Mwanza, Tanzania. balumukad@gmail.com
authors.forename: Deo D
authors.initials: DD
authors.lastname: Balumuka
authors.forename: Phillipo L
authors.initials: PL
authors.lastname: Chalya
authors.forename: William
authors.initials: W
authors.lastname: Mahalu
mesh_terms: D002424:Caustics / Q000506:poisoning; D002648:Child; D004939:Esophageal Perforation / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D005260:Female; D005547:Foreign Bodies / Q000150:complications; D006801:Humans; D008297:Male; D013406:Suicide, Attempted; D013636:Tanzania; D055815:Young Adult
chemical_list: D002424:Caustics