Perforation and rupture of the esophagus

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Switzerland

Christian Toso
Professor
Christian Toso
Head of Division

Perforation of the esophagus can be accidental (ingestion of sharp items) or caused by ingestion of caustic substances. In rare cases, it can result from extreme vomiting (Boerhaave syndrome).

Symptoms of esophagus perforation

The most common symptoms of perforated esophagus are severe pain in the chest, mainly behind the sternum (retrosternal pain) and when swallowing (odynophagia). Depending on the lesion, symptoms may include crackling under the skin (emphysema), as well as breathing difficulties (dyspnea).

Main risk of esophagus perforation

In the event of a confirmed perforation, the main risk is infection of the chest tissues.

The diagnosis is established by an abdominal CT scan, with ingestion of contrast product, and by upper endoscopy (gastroscopy).

Treatment for perforation of the esophagus

To treat a perforated esophagus, endoluminal negative pressure therapy is used. This is a minimally invasive method where a sponge (EndoSponge) is temporarily placed endoscopically (endoscopy ) at the perforation level, in order to aspirate any pus and allow healing. The patient is also treated with antibiotics.

If the health status worsens, esophagectomy and chest drainage are required.

Endoscopy
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Method to visualize the internal organs and cavities for diagnostic or therapeutic purposes, carried out using an endoscope, a tube to which the end is attached to a lamp and a camera
INFO + Echo-endoscopy
Esophagectomy
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Ablation surgery of the esophagus
Last update : 22/07/2021