[Observations related to causes and treatment of iatrogenic esophageal injuries]

One hundred and nine patients were treated in the years 1974-1996 at the Clinic of Thoracic Surgery, Silesian Academy of Medicine, for oesophageal perforation. The group consisted of 72 (66%) men and 37 (34%) women aged 6-89, mean 43 years. In 80 (73%) patients the condition was caused by foreign bodies and endoscopic interventions attempting to remove them, in 9 (8%) by dilation in result of postburn stenosis, in 6 (5%) by trauma, in 8 (7%) by spontaneous rupture, in 6 (5.5%) by other reasons, like tumor or burn. The injury was found within cervical segment in 53 (49%) patients, within thoracic segment in 55 (50%) patients and within abdominal segment in 1 (1%) patients. Fifty seven (52%) patients were admitted sooner than 24 hours after oesophageal injury while 52 (48%) were admitted later than that. A total of 21 (19.3%) patients died, including 3 (5.2%) of the former group and 18 (34.6%) of the latter. Surgical closure of the oesophageal perforation was applied in 40 (37%) patients- of them 4 (10%) died. Four patients with late (exceeding 24 h) diagnosis of oesophageal perforation had thoracotomy and two-layer closure. All of them have survived.