Esophageal perforation as a complication of esophagogastroduodenoscopy

J Hosp Med. 2008 May;3(3):256-62. doi: 10.1002/jhm.289.


Fifty years ago, esophageal perforation was common after rigid upper endoscopy. The arrival of flexible endoscopic instruments and refinement in technique have decreased its incidence; however, esophageal perforation remains an important cause of morbidity and mortality. This complication merits a high index of clinical suspicion to prevent sequelae of mediastinitis and fulminant sepsis. Although the risk of perforation with esophagogastroduodenoscopy alone is only 0.03%, this risk can increase to 17% with therapeutic interventions in the setting of underlying esophageal and systemic diseases. A wide spectrum of management options exist, ranging from conservative treatment to surgical intervention. Prompt recognition and management, within 24 hours of perforation, is critical for favorable outcomes.

Publication types

  • Review

MeSH terms

  • Endoscopy, Digestive System / adverse effects*
  • Esophageal Perforation / diagnosis
  • Esophageal Perforation / etiology
  • Esophageal Perforation / therapy*
  • Esophagus / anatomy & histology
  • Humans
  • Risk Factors