Appleton D S, Sandrasagra F A, Flower C D
Clin Radiol. 1979 Sep;30(5):493-7. doi: 10.1016/s0009-9260(79)80178-6.
Oesophageal perforation is a potentially lethal condition which requires early diagnosis and prompt surgical management. The radiological features in 28 patients with oesophageal perforation have been reviewed and correlated with the aetiology and site of perforation, underlying oesophageal abnormality and the time interval between occurrence and diagnosis. Twenty-five patients (89%) had detectable abnormalities on the chest radiograph. The commonest abnormalities were air in the cervical or mediastinal soft tissues and air or fluid in the pleural cavity. The factors influencing the different radiographic signs are discussed. Studies with a suitable contrast medium are necessary to show the site and extent of the perforation, the extent of any associated abscess cavity and the position of the perforation relative to any primary oesophageal disease. Of 26 patients who had a barium swallow a leak was demonstrated in 21 (81%). In the five patients in whom no leak was demonstrated the examination was performed more than 24 h after the perforation.
食管穿孔是一种潜在的致命疾病，需要早期诊断并迅速进行外科治疗。回顾了28例食管穿孔患者的影像学特征，并将其与穿孔的病因、部位、潜在的食管异常以及发病与诊断之间的时间间隔进行了关联分析。25例患者（89%）胸部X线片上有可检测到的异常。最常见的异常是颈部或纵隔软组织内的气体以及胸腔内的气体或液体。讨论了影响不同影像学表现的因素。使用合适的造影剂进行检查对于显示穿孔的部位和范围、任何相关脓肿腔的范围以及穿孔相对于任何原发性食管疾病的位置是必要的。在26例行钡剂吞咽检查的患者中，21例（81%）显示有漏出。在5例未显示漏出的患者中，检查是在穿孔后24小时以上进行的。
