[Esophageal perforation]

We describe our experience in the management of esophageal perforation.

Retrolective study of the esophageal perforation patients, managed from January 1999 to December 2003. Analyzed variables were age, sex, aetiology, time of diagnosis and treatment, as well as ancillary methods employed, mode of treatment and morbidity and mortality.

We found 13 patients: eight males (61.54%) and five females (38.46%), with an average age of 36.07 years with standard deviation of 19.77. Penetrating trauma was the leading cause in six cases, continued by iatrogenic perforation in four, Boerhaave's syndrome in one, foreign body in one, and blunt abdominal trauma in one. The principal symptom was pain in 84.61% of the cases. The esophagogram confirmed diagnosis in six cases (46.15%). The diagnosis was accomplished early in eight patients (61.54%) and late in five patients (38.46%). Nonsurgical treatment was carried out in two cases (15.38%) and surgical in 11 patients (84.62%). The average hospital stay was 22.45 days. Mortality in general was 15.38%, 0% for those with an early diagnosis and management and 40% for those delayed.

An early diagnosis of esophageal perforation with the appropriate management (surgical or nonsurgical) will considerably diminish patient morbidity and mortality. A treatment choice could not be defined for the early or late diagnosis, but if surgical treatment is undertaken, adequate drainage for the perforation should be instituted as one of its principles.