[Esophageal perforation: surgical outcomes in a referral center]

Esophageal perforation is a rare and potentially life-threatening condition. Its main etiologies include iatrogenic, traumatic, and neoplastic causes. Diagnosis is based on imaging and endoscopic studies. Although some cases can be managed conservatively, most require endoscopic or surgical interventions.

A case study was conducted analyzing the clinical characteristics, treatment, and outcomes of patients with esophageal perforation treated at a referral hospital between 2019 and 2023. Twenty patients were included, with a mean age of 52 years and a predominance of men. The most frequent perforation sites were the cervical and abdominal regions, followed by the thoracic region. The etiology was iatrogenic in 13 cases and traumatic in 7 patients. The most common symptoms were pain, edema, and purulent drainage, and the predominant radiographic finding was contrast medium leakage. The mean time to diagnosis was 5.5 days. All patients required surgical management: primary closure in 4 cases, primary closure with jejunostomy in 5, primary closure with muscle patch in 3, and esophagectomy with esophagostomy and jejunostomy in 8 patients. The overall mortality rate was 20%.

In this series, a high proportion of late diagnoses were observed, related to the time of referral to the unit; however, all patients required surgical treatment. Despite this, the observed mortality rate was comparable to that reported in the international literature.