title: Successful surgical treatment of a complicated esophageal perforation, by use of primary closure and lung parenchyma reinforcement.
abstract: Esophageal perforation (EP) is a medical condition which demands urgent confrontation with significant complications. The cause of the perforation may be common, spontaneous or iatrogenic, with conservative or surgical therapeutic strategy, which is needed in the majority of incidents, depending on the characteristics of the lesion. We report a case of a 68-year-old man, with the existence of an ulcerative lesion 31 cm approximately from the dental barrier, and a coexistent stenosis, diagnosed through esophagogastroduodenoscopy, which evolved to an extensive purulent necrotic mediastinitis, diagnosed through a thorax CT scan after the patient began to complain of asphyxiation during eating. A right posterolateral thoracotomy was performed along with intensive wide spectrum antibiotic therapy. Primary closure of the perforation as well as pulmonary tenting was used with satisfactory results. There was no evidence of leakage after a 12-month "follow-up" period. The early diagnosis of an EP combined with immediate surgical procedure and frequent "follow-up" of the patient, eliminate the risks for the patient's life and ensure a satisfactory outcome.
authors.forename: Nikolaos C
authors.initials: NC
authors.lastname: Schizas
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Paliouras
authors.forename: Thomas
authors.initials: T
authors.lastname: Rallis
authors.forename: Apostolos S
authors.initials: AS
authors.lastname: Gogakos
authors.forename: Achilleas
authors.initials: A
authors.lastname: Lazopoulos
authors.forename: Fotios
authors.initials: F
authors.lastname: Chatzinikolaou
authors.affiliation: Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.
authors.forename: Pavlos
authors.initials: P
authors.lastname: Sarafis
authors.affiliation: Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
authors.affiliation: Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Katsikogiannis
authors.affiliation: Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece.
authors.forename: Eirini
authors.initials: E
authors.lastname: Sarika
authors.affiliation: Ear, Nose and Throat Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
authors.forename: Ιlias
authors.initials: Ι
authors.lastname: Karapantzos
authors.affiliation: Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Charalampidis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Barbetakis
keywords: Esophagus; drainage; perforation; thoracotomy