Esophageal perforations: new perspectives and treatment paradigms

J Trauma. 2007 Nov;63(5):1173-84. doi: 10.1097/TA.0b013e31805c0dd4.


Despite significant advances in modern surgery and intensive care medicine, esophageal perforation continues to present a diagnostic and therapeutic challenge. Controversies over the diagnosis and management of esophageal perforation remain, and debate still exists over the optimal therapeutic approach. Surgical therapy has been the traditional and preferred treatment; however, less invasive approaches to esophageal perforation continue to evolve. As the incidence of esophageal perforation increases with the advancement of invasive endoscopic procedures, early recognition of clinical features and implementation of effective treatment are essential for a favorable clinical outcome with minimal morbidity and mortality. This review will attempt to summarize the pathogenesis and diagnostic evaluation of esophageal injuries, and highlight the evolving therapeutic options for the management of esophageal perforation.

Publication types

  • Review

MeSH terms

  • Adult
  • Burns, Chemical / complications
  • Child
  • Clinical Protocols
  • Endoscopy / methods
  • Esophageal Diseases / diagnosis
  • Esophageal Diseases / physiopathology
  • Esophageal Diseases / therapy
  • Esophageal Perforation / diagnosis*
  • Esophageal Perforation / etiology
  • Esophageal Perforation / physiopathology
  • Esophageal Perforation / therapy*
  • Esophagoplasty / methods
  • Foreign Bodies / complications
  • Humans
  • Iatrogenic Disease
  • Minimally Invasive Surgical Procedures / methods
  • Rupture, Spontaneous / diagnosis
  • Rupture, Spontaneous / physiopathology
  • Rupture, Spontaneous / therapy
  • Treatment Outcome