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Updated: Aug 6, 2026
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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Oesophageal ruptures and perforations--a review
1Royal Brisbane Hospital, Herston.
The Medical Journal of Australia
|March 6, 1989
Summary
Early diagnosis and treatment of esophageal ruptures are crucial for survival. While iatrogenic injuries are increasing, both surgical and conservative management yield excellent outcomes when initiated promptly.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Thoracic Surgery
Background:
- Esophageal ruptures, particularly spontaneous ones, have high mortality rates.
- Iatrogenic esophageal perforations are rising due to increased endoscopic procedures.
Purpose of the Study:
- To review outcomes of esophageal perforations treated over 15 years.
- To evaluate the effectiveness of surgical and conservative management strategies.
Main Methods:
- Retrospective analysis of 23 cases of esophageal perforation.
- Assessment of management based on patient condition and contrast media extravasation.
Main Results:
- Excellent outcomes were achieved with both surgical and conservative treatments.
- Prompt diagnosis correlated with excellent surgical treatment results.
Conclusions:
- Not all esophageal perforations necessitate immediate surgery.
- Timely diagnosis is key to successful surgical intervention for esophageal ruptures.
Related Concept Videos
01:22Esophageal Perforation-I: Introduction
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
01:28Esophageal Perforation-II: Clinical Manifestations and Management
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
01:30Esophageal Strictures-I: Introduction
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
01:24Esophageal Varices-I: Introduction
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01:25Hiatal Hernia
A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or heavy...
01:07Intestinal Obstruction II: Pathophysiology
Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...