Treatment of cervical esophageal perforation caused by foreign bodies

Abstract

In this article, we reviewed our experience of treatment of cervical esophageal perforation caused by foreign bodies. Between 1980 and 2010, 42 patients were included in this study. There were 18 women and 24 men with a median age of 54 years. We divided the patients into three groups: the patients whose foreign bodies could not be extracted by otolaryngologists using endoscope (n= 7), the patients who had some signs of abscess formation but the foreign bodies had been extracted using endoscope (n= 25), and the patients who had no signs of abscess formation and the foreign bodies had been extracted (n= 10). We treated the patients of the three groups with surgical treatment, drainage alone, and conservative treatment, respectively. The outcome of the current series was favorable. Our experience suggested that most of the cases can be treated conservatively or by drainage alone. If the foreign bodies of the esophagus could not be extracted using endoscope, surgical treatment including the removal of the foreign bodies, primary repair, and drainage should be performed.

Aerodigestive Foreign Bodies in Adult Ethiopian Patients: A Prospective Study at Tikur Anbessa Hospital, Ethiopia

“…This is supported by the fact that one of our patients who has swallowed a sharp piece of bone and presented after 5 days with esophageal perforation and cervical abscess collection. Some authors recommend that when cervical esophageal perforation is diagnosed after 48 hours, the treatment of preference is lateral neck incision, abscess drainage, foreign body extraction, limited attempt of esophageal repair, and prolonged drainage of the incision with nutritional support [16]. We have followed this protocol and our patient showed a complete recovery.…”

Perforated esophageal intervention focus (PERF) study: a multi-center examination of contemporary treatment

“…The causes of perforation are myriadincluding iatrogenic injury, trauma, Boerhaave's syndrome, and as a complication of various preexisting esophageal conditions. [1][2][3][4][5]7,12,19 Traditional treatment algorithms have relied upon the rapid delineation of the offending lesion's location using endoscopy or radiographic studies, and determination of time from rupture to guide subsequent therapy. [3][4][5][6]14 Time from diagnosis, physiologic condition at presentation, performance status of the patient, and efficacy of the chosen initial intervention to treat the perforation have all been documented to be associated with patient outcome.…”

Placement of transnasal drainage catheter and covered esophageal stent for the treatment of perforated esophageal carcinoma with mediastinal abscess

“…The incidence of mediastinal abscess is low, and it commonly occurs secondary to the following factors: downward spread of neck infections, operation, tracheal endoscopy-guided mediastinal biopsy, presence of a foreign body in the esophagus, and presence of an esophagomediastinal fistula. The associated mortality rate is high at 40%, because of delayed diagnosis and treatment [1][2][3]. Esophageal carcinoma can infiltrate the esophageal tissue, and an esophagomediastinal fistula is formed when cancerous tissue undergoes necrosis and ulceration.…”