RT Journal Article
SR Electronic
T1 Treatment of instrumental oesophageal perforation.
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 398
OP 404
DO 10.1136/gut.25.4.398
VO 25
IS 4
A1 I C Wesdorp
A1 J F Bartelsman
A1 K Huibregtse
A1 F C den Hartog Jager
A1 G N Tytgat
YR 1984
UL http://gut.bmj.com/content/25/4/398.abstract
AB Results of a conservative approach in the treatment of instrumental oesophageal perforation were evaluated in 54 patients. The perforations occurred either during introduction of/or manipulation with fibre-endoscopes (six), during dilatation procedures with metal olives (five), mercury bougies (six) or during pneumodilatation (two) in 19 patients without malignancy and during an intubation procedure of a plastic prosthesis in 35 patients with an inoperable malignant oesophageal narrowing. In the majority of patients (94.4%) the diagnosis of oesophageal perforation was made within two hours. Conservative treatment consisted of nothing by mouth, antibiotics and naso-oesophageal suction. Of the 19 patients without malignancy, 14 were treated conservatively and five by surgery (primary closure and drainage) with no deaths. All patients with an oesophageal perforation caused by palliative intubation received conservative treatment with three deaths (8.6%). Non-surgical treatment of instrumental oesophageal perforation is feasable and acceptable, provided the perforation is detected early, before major contamination has occurred and is indicated in case of perforation in patients with malignancy.