Rodríguez Taboada J, Belio Castillo C, León Díaz F
Bol Med Hosp Infant Mex. 1976 Nov-Dec;33(6):1235-46.
The experience on perforation of the esophagus at the Hospital Infantil de México is reviewed. Between 1961 and 1975, 20 cases were attended. The most frequent perforation is the iatrogenic subsequent to dilatations or to esophagoscopy. Esophageal perforation is the most serious of the digestive tube perforations and must be considered as a real medicosurgical emergency. The clinical picture is analyzed and the necessity to take chest x-rays and esophagogram as urgent measures is emphasized at the slightest clinical doubt. The different treatment methods are mentioned and it is stressed that the best results are obtained with an urgent thoracotomy, closure of the perforation, full canalization and antibiotic therapy at high doses. According to the literature referred and to the results obtained from the present study, mortality is higher in cases where treatment is delayed. The clinical and radiological pictures are described together with the therapeutic behavior in spontaneous perforation in the newborn. The theories to explain this etiology are set forth. At present, mortality is still high; therefore, in order to bring down this high percentage, it is concluded that an early diagnosis together with an agressive surgical treatment are necessary.
本文回顾了墨西哥儿童医院食管穿孔的治疗经验。1961年至1975年间，共收治20例食管穿孔病例。最常见的穿孔类型是扩张术或食管镜检查术后的医源性穿孔。食管穿孔是消化道穿孔中最严重的一种，必须被视为真正的医疗外科急症。分析了临床表现，并强调在 slightest 临床怀疑时，应立即进行胸部X光检查和食管造影作为紧急措施。文中提及了不同的治疗方法，并强调紧急开胸手术、穿孔修补、充分引流和大剂量抗生素治疗能取得最佳效果。根据参考文献及本研究结果，治疗延迟的病例死亡率更高。文中描述了新生儿自发性穿孔的临床和放射学表现以及治疗方法。阐述了解释该病因的理论。目前，死亡率仍然很高；因此，为了降低这一高比例，得出结论认为早期诊断和积极的手术治疗是必要的。
