title: [Treatment of esophageal perforation complicated with lethal massive hemorrhage induced by foreign body].
abstract: OBJECTIVE
  To explore the clinical characteristics and therapies for esophageal perforation complicated with lethal massive hemorrhage caused by esophageal foreign body.
  
  
  METHODS
  To retrospective analysis the treatment of massive hemorrhage at the carotid artery or aorta caused by esophageal foreign body in forty seven patients, Foreign body characters, surgical approaches, and postsurgical management were summarized.
  
  
  RESULTS
  Among 24 patients with cervical esophageal foreign body, the object was removed either by esophagoscopy or through lateral cervical incision. After controlling carotid artery hemorrhage and repairing Fistula of artery from cervical incision, 19 patients survived. For the 23 patients with thoracic esophageal foreign body accompanied with aorta hemorrhea, thoracotomy was performed to remove the foreign body and repair the aortic fistula. Only 3 of these 23 patients recovered from the emergent surgery, other 20 patients died.
  
  
  CONCLUSIONS
  For the patients with esophageal foreign body inducing large vessel impingement, the most reliable therapeutic method is surgical repairing of arterial perforation and extraction of the foreign body via cervical or thoracic incision. Carotid ligation should be considered in patients with recurrent carotid hemorrhage. For the patient with mediastinitis, esophageal exclusion is recommended to prevent infection and to promote healing of aortic perforation after aortic fistula repairing.
authors.forename: Peng
authors.initials: P
authors.lastname: Hu
authors.forename: Youzhong
authors.initials: Y
authors.lastname: Li
authors.forename: Qin
authors.initials: Q
authors.lastname: Wang
authors.forename: Dinghua
authors.initials: D
authors.lastname: Xie
authors.forename: Xinming
authors.initials: X
authors.lastname: Yang
authors.forename: Ganghua
authors.initials: G
authors.lastname: Zhu
mesh_terms: D000328:Adult; D004939:Esophageal Perforation / Q000209:etiology / Q000601:surgery*; D004947:Esophagus; D005260:Female; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000150:complications*; D006470:Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies