[Perforation of the esophagus. A review of 12 cases (author's transl)].

Perforation of the esophagus is a very serious condition which is nearly always fatal, unless it can be diagnosed and treated at the earliest possible moment. Ten thousand case histories in a Department of Internal Medicine and a Department of Surgery were reviewed, among which 12 cases of esophageal perforation were found. The overall mortality in this series was 59 percent; the mortality of the surgically treated group was 39 percent. Four of the five patients operated on within the first 24 hours survived. The prognosis was poor when the lower third of the esophagus was ruptured. Esophageal perforations are becoming increasingly more frequent because of the widespread practice of endoscopy. The clinical symptoms of the condition include subcutaneous emphysema, retrosternal pain and dispnea. X-rays often show air or fluid in the mediastinum, air and fluid in the pleural space, and evidence of rupture when opaque contrast material is employed. These signs should usually by sufficient for an early diagnosis. Surgery is the treatment of choice.