[Esophageal injuries]

The authors present an analysis of 33 oesophageal injuries treated at the surgical clinic of Faculty Hospital Plzen in 1976-1991. Iatrogenic injuries predominated (a total of 24 cases). Of these seven developed during oesophagoscopy performed on account of dysphagic complaints caused by benign or malignant disease. Ten injuries developed in conjunction with endoscopic extraction of a foreign body, three occurred during operation of hiatus hernia, two during sclerotization of oesophageal varices and one each during insertion of a nasogastric tube and oesophageal endoprosthesis. In the remaining cases perforation occurred during traumatic injury of the neck four times, twice as a result of a swallowed bone, and three perforations were spontaneous. The total mortality was 27.3%. The authors analyze factors which influence the morbidity and mortality--the site of injury, the time which elapsed between injury and treatment, the patient's age, mode of injury, associated diseases and method of treatment. They found that the most frequent complication and most frequent cause of death was septicaemia from mediastinitis and empyema of the chest.