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Traumatic oesophageal perforation

I Inci1, C Ozcelik, O Nizam

  • 1Department of Thoracic and Cardiovascular Surgery, Dicle University School of Medicine, Diyarbakir, Turkey.

Scandinavian Cardiovascular Journal : SCJ
|January 1, 1997
PubMed
Summary
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Prompt diagnosis and treatment of traumatic oesophageal perforation are crucial for survival. Delayed medical intervention significantly increases mortality risk, highlighting the need for a high index of suspicion in trauma cases.

Area of Science:

  • Gastroenterology
  • Trauma Surgery
  • Thoracic Surgery

Background:

  • Traumatic oesophageal perforation is a rare but life-threatening injury.
  • Management strategies for oesophageal perforation, particularly when delayed, remain controversial.

Purpose of the Study:

  • To evaluate treatment outcomes for traumatic oesophageal perforation.
  • To assess the impact of diagnostic delay on patient mortality.
  • To review surgical interventions and complication rates.

Main Methods:

  • Retrospective analysis of 16 patients treated for traumatic oesophageal perforation over 16 years.
  • Review of injury mechanisms (penetrating vs. blunt), time to treatment, surgical procedures, and complications.
  • Comparison of mortality rates based on treatment delay (within vs. after 24 hours).

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Main Results:

  • 14 of 16 injuries were penetrating; median delay to treatment was 32 hours.
  • Treatments included primary closure, drainage, and oesophageal exclusion.
  • Mortality was higher in patients treated after 24 hours (50%) compared to those treated within 24 hours (25%).

Conclusions:

  • Delayed diagnosis of oesophageal perforation is associated with significantly increased mortality.
  • A high index of suspicion is vital for prompt diagnosis and improved patient outcomes.
  • Individualized treatment approaches are recommended for late-diagnosed oesophageal perforations.