[Iatrogenic injury of the esophagus]

The author describes four patients treated in 1988 on account of iatrogenic oesophageal injury during diagnostic endoscopy. Twice the cervical portion of the oesophagus was perforated, once the lower thoracic portion and once subperitoneal perforation in hiatus hernia was involved. The latter was manifested only by a major pneumomediastinum and emphysema of the neck and face, while contrast examination of the oesophagus and stomach did not suggest perforation and recovery was achieved by conservative treatment. In the remaining three patients surgical revision and suture were performed and complete recovery was achieved, twice without complications after a hospitalization of 14 and 18 days and once the course was complicated by an abscess in the mediastinum. Its treatment called for repeated drainage and a total hospitalization period of 57 days. Finally the author emphasizes that early diagnosis of this serious complication and subsequent early treatment (with the exception of one female patient the others were treated within six hours after the injury) may get the patient over this complication without serious damage.