A - 13 Years of Single-Center Experience in the Management and Outcome of Esophageal Perforation
Alawady, T., Elsharawy, M., Mansour, A., Elshahidy, T., Abdelsalam, A. (2022). A - 13 Years of Single-Center Experience in the Management and Outcome of Esophageal Perforation. EKB Journal Management System, 28(6), 1281-1288. doi: 10.21608/zumj.2022.139208.2568
Tamer Salem Alawady; Mamdouh Elsharawy; Amr Hassan Mansour; Tamer Mohamed Elshahidy; Ashraf Hamed Abdelsalam. "A - 13 Years of Single-Center Experience in the Management and Outcome of Esophageal Perforation". EKB Journal Management System, 28, 6, 2022, 1281-1288. doi: 10.21608/zumj.2022.139208.2568
Alawady, T., Elsharawy, M., Mansour, A., Elshahidy, T., Abdelsalam, A. (2022). 'A - 13 Years of Single-Center Experience in the Management and Outcome of Esophageal Perforation', EKB Journal Management System, 28(6), pp. 1281-1288. doi: 10.21608/zumj.2022.139208.2568
Alawady, T., Elsharawy, M., Mansour, A., Elshahidy, T., Abdelsalam, A. A - 13 Years of Single-Center Experience in the Management and Outcome of Esophageal Perforation. EKB Journal Management System, 2022; 28(6): 1281-1288. doi: 10.21608/zumj.2022.139208.2568

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, Page 1281-1288  XML PDF (327.85 K)
Document Type: Original Article
DOI: 10.21608/zumj.2022.139208.2568
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Authors
Tamer Salem Alawady email 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
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