Shaheem Shaima, Panikkaveettil Hasina
Internal Medicine, Medical University of Plovdiv, Plovdiv, BGR.
Internal Medicine, Our Lady's Hospital, Navan, IRL.
Cureus. 2024 Feb 27;16(2):e55041. doi: 10.7759/cureus.55041. eCollection 2024 Feb.
Oesophageal perforation (OP) is a life-threatening condition and refers to a tear or disruption in the oesophageal wall. It is considered a medical emergency due to its significant implications, often related to its various causes, such as iatrogenic perforation during endoscopy, Boerhaave syndrome, traumatic injury, foreign body ingestion, and tumour perforation. Early interventions, diagnosis, and a thorough physical examination are essential for better clinical outcomes. Diagnostic procedures and imaging techniques, play a crucial role in confirming OP. The diagnostic workup, based on the index of suspicion, may involve barium oesophagram or contrast-enhanced CT. Once diagnosed, classification of severity using the Pittsburgh clinical severity score guides treatment decisions. Management can be non-surgical or surgical and focuses on a multi-disciplinary approach combining conservative, surgical, or endoscopic methods. Surgical control remains crucial, with the approach dependent on the location of the leak. Improved knowledge of this life-threatening condition is important among healthcare professionals. The objective of this review is to provide information about oesophageal perforation and its early detection, management, and multidisciplinary interventions for optimal patient outcomes.
食管穿孔（OP）是一种危及生命的病症，指食管壁的撕裂或破裂。由于其具有重大影响，通常与多种病因相关，如内镜检查期间的医源性穿孔、博雷尔哈夫综合征、外伤、异物吞食和肿瘤穿孔，因此被视为医疗急症。早期干预、诊断以及全面的体格检查对于取得更好的临床结果至关重要。诊断程序和成像技术在确诊OP方面发挥着关键作用。基于怀疑指数的诊断检查可能包括食管钡餐造影或增强CT。一旦确诊，使用匹兹堡临床严重程度评分对严重程度进行分类可指导治疗决策。治疗可采用非手术或手术方式，重点是结合保守、手术或内镜方法的多学科方法。手术控制仍然至关重要，手术方式取决于渗漏部位。提高医护人员对这种危及生命病症的认识很重要。本综述的目的是提供有关食管穿孔及其早期检测、管理和多学科干预的信息，以实现最佳患者预后。
