Jones W G, Ginsberg R J
Division of Thoracic Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021.
Ann Thorac Surg. 1992 Mar;53(3):534-43. doi: 10.1016/0003-4975(92)90294-e.
Perforation of the esophagus remains a diagnostic and therapeutic challenge. Currently, the most common cause of perforation is instrumentation of the esophagus, and the incidence of esophageal perforations has increased as the use of endoscopic procedures has become more frequent. Diagnosis depends on a high degree of suspicion and recognition of clinical features, and is confirmed by contrast esophagography or endoscopy. Outcome after esophageal perforation is dependent on the cause and location of the injury, the presence of underlying esophageal disease, and the interval between injury and initiation of treatment. Reinforced primary repair of the perforation is the most frequently employed and preferable approach to the surgical management of esophageal perforations. Nonoperative management consisting of antibiotics and parenteral nutrition is particularly successful for limited esophageal injuries meeting proper selection criteria.
食管穿孔仍然是一个诊断和治疗难题。目前，穿孔最常见的原因是食管器械操作，并且随着内镜检查程序使用得越来越频繁，食管穿孔的发生率有所增加。诊断依赖于高度的怀疑以及对临床特征的识别，并通过食管造影或内镜检查得以证实。食管穿孔后的结果取决于损伤的原因和部位、潜在食管疾病的存在以及损伤与开始治疗之间的间隔时间。穿孔的加强一期修复是食管穿孔外科治疗中最常用且更可取的方法。对于符合适当选择标准的有限食管损伤，由抗生素和肠外营养组成的非手术治疗尤其成功。
