Esophageal Perforation- Presentation, Management, Outcome and Review of Literature
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 3
Abstract
Objective: To analyze the indications and outcome for conservative Non-operative treatment (NOT) vs. Operative Treatment (OT) in patients with esophageal perforation with a Secondary intention to analyze the etiology and presentation of patients with esophageal perforation. Methodology: It is a retrospective observational study of all patients admitted with esophageal perforation in the Institute of Surgical Gastroenterology, Rajiv Gandhi Government General Hospital, Madras Medical College, Tamilnadu, India, during the period from January 2012 to December 2017. Records of all these patients were studied retrospectively and their etiology, management and outcome in terms of 30-day mortality, mean hospital stay and overall morbidity and mortality were analyzed. Results: Totally 39 patients with esophageal perforation were analyzed. Of which 15 were early presentation (<24hr), 24 were late presentation (>24hr). Most common etiology was foreign body induced perforation. Based on the level seven were cervical perforation and the remaining thoracic esophageal perforation. 32 patients underwent surgery and seven were managed conservatively. There were five mortality. Out of which four were in the late group. Morbidity and hospital stay were more in the late group when compared to early group. Conclusion: Early diagnosis and management are essential in esophageal perforation. Management should be individualized based on patient presentation and level of perforation.
Authors and Affiliations
Srinivasan Ulagendraperumal, Obla Lakshmanamoorthy Naganath Babu, L Soundara Rajan, Chandramohan SM
Keywords
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