Management of late cases of esophageal disruption with intravenous hyperalimentation

Among fourteen patients with disruption of the thoracic esophagus, the overall mortality rate was 36%. The mortality was greatly reduced in a group of five of these patients who were treated by closed-chest tube drainage and intravenous hyperalimentation. The cause of death in most cases was sepsis and malnutrition. Although the ideal treatment in early cases of eosphageal disruption is thoracotomy and direct suture, it is believed that in patients presenting late, in old and debilitated patients, and in cases of a leaking thoracic anastomosis, the mortality will be greatly improved by the use, primarily, of conservative measures,, with the addition of intravenous hyperlimentation.