Shepherd R L, Raffensperger J G, Goldstein R
J Thorac Cardiovasc Surg. 1977 Aug;74(2):261-7.
Although esophageal perforation in children is associated with a spectrum of disease different from the one in adults, management is essentially the same for both groups. Over the past 11 years, 12 patients ranging in age from 2 days to 10 years were treated for 13 perforations. Perforation in the adult is associated with a high mortality rate. All children in this series survived. Injury was secondary to instrumentation in 10 cases and three resulted from the chronic erosion of a trapped foreign body. Of the 10 acute perforations, five occurred 12 days to 5 months after lye ingestion. Anastomotic narrowing was a factor in three other cases. Seven of the acute perforations involved the thoracic esophagus and were associated with a high morbidity rate. Management consisted of operative as well as nonoperative approaches. Consideration must be given to several clinical variables including location, cause, predisposing factors, underlying illnesses, associated injury, and promptness of medical attention.
尽管儿童食管穿孔与成人食管穿孔的疾病谱不同，但两组的治疗原则基本相同。在过去11年中，对年龄从2天至10岁的12例患者的13处穿孔进行了治疗。成人食管穿孔的死亡率很高。本系列中的所有儿童均存活。10例损伤继发于器械操作，3例由嵌顿异物的慢性侵蚀所致。在10例急性穿孔中，5例发生在吞服烧碱后12天至5个月。吻合口狭窄是另外3例的一个因素。7例急性穿孔累及胸段食管，且发病率很高。治疗包括手术和非手术方法。必须考虑几个临床变量，包括穿孔部位、病因、易感因素、基础疾病、合并损伤以及医疗救治的及时性。
