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Esophageal Perforation-I: Introduction

Esophageal 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.
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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:

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Related Experiment Video

Updated: Sep 15, 2025

Flexible Colonoscopy in Mice to Evaluate the Severity of Colitis and Colorectal Tumors Using a Validated Endoscopic Scoring System

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Published on: October 16, 2013

Stratifying Endoscopic Submucosal Dissection Risks: A Validated Perforation Preoperative Risk Scoring Tool.

Attila Ulkucu¹, Mariano Laporte, Imran Khan

¹Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.

Annals of Surgery

|July 16, 2025

Summary

This summary is machine-generated.

A new Endoscopic Submucosal Dissection (ESD) risk model predicts perforation, enhancing patient safety. Key predictors include fibrosis, early cases, and large lesion size (>35mm).

Keywords:

colorectal neoplasms endoscopic submucosal dissection intestinal perforation predictive model risk assessment risk factors

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Last Updated: Sep 15, 2025

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Area of Science:

Gastroenterology
Surgical Oncology
Medical Device Technology

Background:

Endoscopic Submucosal Dissection (ESD) offers minimally invasive colorectal lesion removal.
ESD procedures carry a risk of perforation, leading to significant patient morbidity.

Purpose of the Study:

To develop and validate a predictive model for perforation risk during colorectal Endoscopic Submucosal Dissection (ESD).
To enhance patient safety by improving preprocedural risk assessment.

Main Methods:

Retrospective review of 1051 patients undergoing colorectal ESD from March 2011 to November 2023.
Data stratified into derivation and validation sets; univariate and multivariate analyses performed.
Receiver Operating Characteristic (ROC) curve analysis used to assess model efficacy.

Main Results:

Perforation occurred in 108 (10%) patients.
Independent predictors of perforation identified: fibrosis (OR: 2.67), early procedures (OR: 14.6), and lesion size >35mm (OR: 3.50).
The validated ESD perforation risk score demonstrated adequate performance (AUC: 0.7078, accuracy: 80.19%).

Conclusions:

A validated Endoscopic Submucosal Dissection (ESD) perforation risk model has been developed.
This model serves as a reliable tool for clinicians to assess patient risk.
The model has the potential to improve preprocedural strategies and patient outcomes.