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Management of Esophageal Perforation in Adults
Perforation of esophagus in the adult is a very morbid condition with high morbidity and mortality. The ideal treatment is controversial. The main causes for esophageal perforation in adults are iatrogenic, traumatic, spontaneous and foreign bodies. The morbidity and mortality rate is directly relat...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elmer Press
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139851/ https://www.ncbi.nlm.nih.gov/pubmed/27942303 http://dx.doi.org/10.4021/gr263w |
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author | Kaman, Lileswar Iqbal, Javid Kundil, Byju Kochhar, Rakesh |
author_facet | Kaman, Lileswar Iqbal, Javid Kundil, Byju Kochhar, Rakesh |
author_sort | Kaman, Lileswar |
collection | PubMed |
description | Perforation of esophagus in the adult is a very morbid condition with high morbidity and mortality. The ideal treatment is controversial. The main causes for esophageal perforation in adults are iatrogenic, traumatic, spontaneous and foreign bodies. The morbidity and mortality rate is directly related to the delay in diagnosis and initiation of optimum treatment. The reported mortality from treated esophageal perforation is 10% to 25%, when therapy is initiated within 24 hours of perforation, but it could rise up to 40% to 60% when the treatment is delayed beyond 48 hours. Primary closure of the perforation site and wide drainage of the mediastinum is recommended if perforation is detected in less than 24 hours. Treatment option for delayed or missed rupture of esophagus is not very clear and is controversial. Recently a substantial number of patients with esophageal perforation are being managed by nonoperative measures. Patients with small perforations and minimal extraesophageal involvement may be better managed by nonoperative treatment Major prognostic factors determining mortality are the etiology and site of the injury, the presence of underlying esophageal pathology, the delay in diagnosis and the method of treatment. For optimum outcome for management of esophageal perforations in adults a multidisciplinary approach is needed. |
format | Online Article Text |
id | pubmed-5139851 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | Elmer Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-51398512016-12-09 Management of Esophageal Perforation in Adults Kaman, Lileswar Iqbal, Javid Kundil, Byju Kochhar, Rakesh Gastroenterology Res Review Perforation of esophagus in the adult is a very morbid condition with high morbidity and mortality. The ideal treatment is controversial. The main causes for esophageal perforation in adults are iatrogenic, traumatic, spontaneous and foreign bodies. The morbidity and mortality rate is directly related to the delay in diagnosis and initiation of optimum treatment. The reported mortality from treated esophageal perforation is 10% to 25%, when therapy is initiated within 24 hours of perforation, but it could rise up to 40% to 60% when the treatment is delayed beyond 48 hours. Primary closure of the perforation site and wide drainage of the mediastinum is recommended if perforation is detected in less than 24 hours. Treatment option for delayed or missed rupture of esophagus is not very clear and is controversial. Recently a substantial number of patients with esophageal perforation are being managed by nonoperative measures. Patients with small perforations and minimal extraesophageal involvement may be better managed by nonoperative treatment Major prognostic factors determining mortality are the etiology and site of the injury, the presence of underlying esophageal pathology, the delay in diagnosis and the method of treatment. For optimum outcome for management of esophageal perforations in adults a multidisciplinary approach is needed. Elmer Press 2010-12 2010-11-20 /pmc/articles/PMC5139851/ /pubmed/27942303 http://dx.doi.org/10.4021/gr263w Text en Copyright 2010, Kaman et al. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Kaman, Lileswar Iqbal, Javid Kundil, Byju Kochhar, Rakesh Management of Esophageal Perforation in Adults |
title | Management of Esophageal Perforation in Adults |
title_full | Management of Esophageal Perforation in Adults |
title_fullStr | Management of Esophageal Perforation in Adults |
title_full_unstemmed | Management of Esophageal Perforation in Adults |
title_short | Management of Esophageal Perforation in Adults |
title_sort | management of esophageal perforation in adults |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139851/ https://www.ncbi.nlm.nih.gov/pubmed/27942303 http://dx.doi.org/10.4021/gr263w |
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