Clinical experiences with perforation of the esophagus

LXXIV Penetrating and Perforating Injuries of the Esophagus

“…This mortality is somewhat higher than that reported by jemerin.l" Doig,'" Mathewson, et ap6,17 Bogedian," Nealon, et al, 19 Elner and Dahlback.P and Bailie, et a1. 2 They report a mortality with instrumental perforations between 17 and 30 per cent. The difference in this series might be accounted for by the fact that patients with injuries other than instrumental perforations were included in the present study.…”

“…This is in keeping with the reported statistics of Elner and Dahlback.P Nealon, et aI., 19 and Mathewson, et aJ.l6. 17 Mosher'" has previously cited anatomical factors which probably make the lower third of the esophagus particularly vulnerable to injury with an esophagoscope. He described the esophageal muscles at the lower end as being conical, tapered and rather thin.…”

Fish Bone Fistulae

“…In one se¬ ries,4 80% of the patients with this problem were under the age of 15 years. However, the site of involve¬ ment is typical as the majority of for¬ eign bodies lodge high in the cervical esophagus.3 5 The second area of pred¬ ilection is the diaphragmatic end of the esophagus and the third is the area of aortic indentation. It should be emphasized that sharp objects, like fish bones, may lodge anywhere along the esophagus.…”

Morbidity and mortality of oesophageal perforation

“…Despite well documented accounts of both the clinical features and radiological diagnosis of oesophageal perforation (Mathewson, Dozier, Hamill, and Smith, 1962;Hardin, Hardy, and Conn, 1967;Abbott et al, 1970), the morbidity and mortality, particularly after spontaneous rupture, remain alarmingly high (Tuttle and Barrett, 1963;Foster, Jolly, Sawyers, and Daniel, 1965). The importance of early diagnosis in avoiding complications (Nealon et al, 1961) and the value of contrast radiology have been stressed (Christoforidis and Nelson, 1957;Kerr, 1962).…”