Esophageal Perforation in Children: A Review of One Institution's Experience

Garey, Carissa L.; Laituri, Carrie A.; Kaye, Adam J.; Ostlie, Daniel J.; Snyder, Charles L.; Holcomb, George; Peter, Shawn D. St.

doi:10.1016/j.jss.2010.05.049

Cited by 46 publications

(40 citation statements)

References 13 publications

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“…Oesophageal perforation is an uncommon but very dangerous injury mostly caused by instrumentation [1]. Treatment of oesophageal perforation depends on; the aetiology, site and size of perforation, the time from perforation to diagnosis, underlying oesophageal disease and the overall health of the patient.…”

Section: Discussionmentioning

confidence: 99%

“…This could be because children have a great propensity to heal [1]. But in a limited therapeutic facility, the only management that could be offered to such patients is conservative, especially in areas where thoracic surgeons are not available.…”

Section: Discussionmentioning

confidence: 99%

“…Nutritional support is of highest priority [1-10]. A nasogastric tube should not be used initially, as it may cause further injury at the site of perforation [3].…”

Section: Discussionmentioning

confidence: 99%

“…The time of healing has ranged from 5 days to 3 months among patients with oesophageal perforations managed by the conservative method [1,3]. …”

Section: Discussionmentioning

confidence: 99%

“…Oesophageal perforation is an uncommon but potentially fatal injury that can quickly progress to mediastinitis, sepsis and multiorgan failure, if early recognition and proper treatment is not instituted [1]. The commonest cause of oesophageal perforation is instrumentation.…”

Section: Introductionmentioning

confidence: 99%

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Oesophageal Perforation: A diagnostic and therapeutic challenge in a resource limited setting. A report of three cases

Balumuka

Chalya

Mahalu

2011

J Cardiothorac Surg

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BackgroundOesophageal perforation is a condition associated with a high mortality. Its management is still controversial with operative treatment being favoured but a shift to conservative management is occurring. Very little exists in medical literature about its management in Sub-Saharan Africa, where the paucity of thoracic surgeons is compounded by limited diagnostic and therapeutic facilities.Case PresentationWe report three cases of oesophageal perforation which were all treated conservatively with tube thoracostomy, nil by mouth with feeding gastrostomy, intravenous antibiotics and chest physiotherapy. Two patients achieved oesophageal healing but one died due to severe septicaemia.ConclusionIn a resource restricted setting, conservative management which includes enteral nutrition by feeding gastrostomy, tube thoracostomy to drain inter pleural contaminants, intravenous antibiotics and chest physiotherapy is a safe and effective treatment for oesophageal perforations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Nutritional support is of highest priority [1-10]. A nasogastric tube should not be used initially, as it may cause further injury at the site of perforation [3].…”

Section: Discussionmentioning

confidence: 99%

“…The time of healing has ranged from 5 days to 3 months among patients with oesophageal perforations managed by the conservative method [1,3]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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