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Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours
Esophageal perforation is a rare and potentially life-threatening condition. Early clinical suspicion and imaging is important for case management to achieve a good outcome. However, recent studies continue to report high morbidity and mortality greater than 20% from esophageal perforation. At least...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3219576/ https://www.ncbi.nlm.nih.gov/pubmed/22035338 http://dx.doi.org/10.1186/1757-7241-19-66 |
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author | Søreide, Jon Arne Viste, Asgaut |
author_facet | Søreide, Jon Arne Viste, Asgaut |
author_sort | Søreide, Jon Arne |
collection | PubMed |
description | Esophageal perforation is a rare and potentially life-threatening condition. Early clinical suspicion and imaging is important for case management to achieve a good outcome. However, recent studies continue to report high morbidity and mortality greater than 20% from esophageal perforation. At least half of the perforations are iatrogenic, mostly related to endoscopic instrumentation used in the upper gastrointestinal tract, while about a third are spontaneous perforations. Surgical treatment remains an important option for many patients, but a non-operative approach, with or without use of an endoscopic stent or placement of internal or external drains, should be considered when the clinical situation allows for a less invasive approach. The rarity of this emergency makes it difficult for a physician to obtain extensive individual clinical experience; it is also challenging to obtain firm scientific evidence that informs patient management and clinical decision-making. Improved attention to non-specific symptoms and signs and early diagnosis based on imaging may translate into better outcomes for this group of patients, many of whom are elderly with significant comorbidity. |
format | Online Article Text |
id | pubmed-3219576 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-32195762011-11-18 Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours Søreide, Jon Arne Viste, Asgaut Scand J Trauma Resusc Emerg Med Review Esophageal perforation is a rare and potentially life-threatening condition. Early clinical suspicion and imaging is important for case management to achieve a good outcome. However, recent studies continue to report high morbidity and mortality greater than 20% from esophageal perforation. At least half of the perforations are iatrogenic, mostly related to endoscopic instrumentation used in the upper gastrointestinal tract, while about a third are spontaneous perforations. Surgical treatment remains an important option for many patients, but a non-operative approach, with or without use of an endoscopic stent or placement of internal or external drains, should be considered when the clinical situation allows for a less invasive approach. The rarity of this emergency makes it difficult for a physician to obtain extensive individual clinical experience; it is also challenging to obtain firm scientific evidence that informs patient management and clinical decision-making. Improved attention to non-specific symptoms and signs and early diagnosis based on imaging may translate into better outcomes for this group of patients, many of whom are elderly with significant comorbidity. BioMed Central 2011-10-30 /pmc/articles/PMC3219576/ /pubmed/22035338 http://dx.doi.org/10.1186/1757-7241-19-66 Text en Copyright ©2011 Søreide and Viste; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Søreide, Jon Arne Viste, Asgaut Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours |
title | Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours |
title_full | Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours |
title_fullStr | Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours |
title_full_unstemmed | Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours |
title_short | Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours |
title_sort | esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3219576/ https://www.ncbi.nlm.nih.gov/pubmed/22035338 http://dx.doi.org/10.1186/1757-7241-19-66 |
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