title: Perforation during esophageal dilatation: a 10-year experience.
abstract: OBJECTIVE
  Esophageal stenosis can be caused by malignant, postsurgical, benign diseases etc. Endoscopic treatment options consist primarily of balloon dilatation and bougination. Both interventions carry a certain risk of further complications such as perforations. We aimed to evaluate this risk in our patients.
  
  
  METHODS
  Frequency, perforation rates, further diagnostics, therapy, outcome and underlying diseases in 368 patients who underwent endoscopic dilatation or bougination in a 10 year period were evaluated.
  
  
  RESULTS
  Overall, 1497 endoscopic interventions were performed for treatment of esophageal stricture, causing 8 perforations (0.53% per intervention, 2.17% per patient) and one lethal outcome (0.05% per intervention, 0.27% per patient). In 1286 bouginations, 8 perforations (0.62%) and one death occurred (0.08%), whilst no perforation was noted during 211 balloon dilatations. Outcome of the 8 perforations was greatly influenced by co-morbidities, causing a prolonged hospitalization and the death of one patient.
  
  
  CONCLUSIONS
  Although complication rates are fairly small, patients should be under supervision or in contact for 24-72 hours after each intervention. In cases where perforation is suspected, radiological examinations should be conducted early. The perforation rate and mortality per patient may be used for patient information. Therapy and prognosis depend on the cause of perforation, localization and size of the perforation site as well as concomitant diseases.
authors.affiliation: Department of Medicine 1, University of Erlangen, Erlangen, Germany; Email:Alexander.Hagel@uk-erlangen.de.
authors.forename: Alexander F
authors.initials: AF
authors.lastname: Hagel
authors.forename: Andreas
authors.initials: A
authors.lastname: Naegel
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Dauth
authors.forename: Klaus
authors.initials: K
authors.lastname: Matzel
authors.forename: Hermann P
authors.initials: HP
authors.lastname: Kessler
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Farnbacher
authors.forename: Werner M
authors.initials: WM
authors.lastname: Hohenberger
authors.forename: Markus F
authors.initials: MF
authors.lastname: Neurath
authors.forename: Martin
authors.initials: M
authors.lastname: Raithel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D004106:Dilatation / Q000009:adverse effects* / Q000401:mortality; D004939:Esophageal Perforation / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D004940:Esophageal Stenosis / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D004945:Esophagoscopy / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D055815:Young Adult