Esophageal intubation in the management of perforated esophagus with stricture

Insertion of a Celestin tube was employed in the treatment of 5 elderly patients who sustained perforations of the thoracic or abdominal esophagus during dilation of benign or malignant strictures. Two perforations treated within 24 hours were closed by direct suture in addition to intubation. There was a delay of 24 to 48 hours between the occurrence of the perforation and treatment in the other 3 cases. Only 1 of the latter patients subsequently developed pleural effusion, and this responded to drainage. One patient died 3 weeks after intubation; there was no evidence to suggest continued leakage through the perforation. The Celestin tube appears to be effective in sealing off esophageal perforations while healing occurs and merits consideration in the management of esophageal perforations associated with stricture in elderly patients when more radical treatment is not envisaged.