Selective nonoperative management of contained intrathoracic esophageal disruptions

Ann Thorac Surg. 1979 May;27(5):404-8. doi: 10.1016/s0003-4975(10)63335-8.


Eight patients with intrathoracic esophageal disruptions were managed nonoperatively and without pleural drainage. Criteria for nonoperative treatment included the following: disruption contained in the mediastinum or between the mediastinum and visceral lung pleura; drainage of the cavity back into the esophagus; minimal symptoms; and minimal signs of clinical sepsis. Cause of the esophageal perforation was pneumostatic dilatation (1 patient), vomiting (2), and a leak following esophageal operation (5). Antibiotics were administered intravenously to all patients; hyperalimentation was accomplished intravenously in 5, and nasogastric suction was used in only 1. The cavities contracted and the esophageal leaks sealed in all instances. Time before oral intake was resumed ranged from 7 to 38 days (average, 18 days). Days until discharge ranged from 15 to 52 days (average, 28 days).

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Dilatation / adverse effects
  • Esophageal Perforation / diagnostic imaging
  • Esophageal Perforation / etiology
  • Esophageal Perforation / therapy*
  • Esophagus / surgery
  • Female
  • Fluid Therapy*
  • Humans
  • Male
  • Middle Aged
  • Parenteral Nutrition*
  • Parenteral Nutrition, Total*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / therapy
  • Radiography
  • Suction
  • Time Factors
  • Vomiting / complications


  • Anti-Bacterial Agents