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 () 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,and chest drainage are required.
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