A - 13 Years of Single-Center Experience in the Management and Outcome of Esophageal Perforation | ||
| Zagazig University Medical Journal | ||
| Article 14, Volume 28, Issue 6, November 2022, Pages 1281-1288 PDF (327.85 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2022.139208.2568 | ||
| Authors | ||
| Tamer Salem Alawady* 1; Mamdouh Elsharawy2; Amr Hassan Mansour3; Tamer Mohamed Elshahidy4; Ashraf Hamed Abdelsalam5 | ||
| 1cardiothoracic surgery department, faculty medicine, zagazig university, zagazig, egypt | ||
| 2Cardiothoracic Surgery, Faculty of Medicine, Zagazig University, Egypt | ||
| 3Department of Cardiothoracic surgery, Zagazig University, Egypt | ||
| 4Faculty of Medicine Zagazig University | ||
| 5Cardiothoracic surgery department, Faculty of Medicine, Zagazig University | ||
| Abstract | ||
| Objective: Esophageal perforation (EP) is a fatal status that continues to be challenging the management, with the incidence of mortality and morbidity has been reported to reach 40%. Its diagnosis may be tricky as it usually presents with a wide range of non-specific symptoms. Our study aims to report characteristics, relay our experience with EP management, and evaluate the various strategies used. Methods: This study retrospectively evaluated the management of 53 patients with EP over 13 years. The confirmed diagnosis was established by esophagogram with water-soluble contrast, contrast-enhanced computed tomography, and esophago-gastro-duodenoscopy. Initial management was categorized as conservation, endoscopic stent, or surgery. Re-intervention and different outcomes were recorded and analyzed. Results: Thoracic EP is the most common location (71.7%). The most common cause of EP was iatrogenic (35.8%). About 58.5% of patients were diagnosed ≤ 24 hours. The mean Pittsburg severity score was 7.5. The initial management was conservation (35.8%), endoscopic stent (17%), and surgical intervention (47.2%). ICU and organ support were needed in 35.8% and 20.8%, respectively. The mean hospital stay for all patients was 27.7 days. Morbidity and mortality were recorded at 30.2% and 18.9%, respectively. Conclusion: EP management should be flexible with a tailored strategy for every patient. Etiology, site, severity score, time to management, and patient reserve are significant factors in management and prognosis. Keywords: Esophageal perforation, drainage, iatrogenic, spontaneous, foreign, conservation | ||
| Keywords | ||
| Keywords: Esophageal perforation; drainage; iatrogenic; spontaneous; conservation | ||
|
Statistics Article View: 208 PDF Download: 218 |
||
