Thoracic esophageal perforations at a Virginia hospital 1979-1990

A study was made of all patients who underwent management for distal esophageal perforation at the Fairfax Hospital from September 1979 to September 1990. The study group consisted of 13 patients. Nine were male, four female. Mean age was 60.8 yrs, ranging from 36 to 83 yrs. In the group of nine patients diagnosed early (less than 24 hrs), hospital mortality was 22.2% versus 75% in the group of four diagnosed late (greater than 24 hrs). Of the six patients treated conservatively, either medically or surgically, only one survived, but all seven patients diagnosed early and aggressively operated upon survived. Thus the authors agree with others in espousing aggressive, definitive surgery for patients diagnosed early.