Instrumental injuries of the healthy esophageal wall occur frequently due to esophagoscope are observed in the upper parts of the esophagus, have a lineal form and large sizes. Instrumental, frequently by bougie, injuries of the esophagus altered by scars are of a smaller size, round shape and localize in the thoracic part of the esophagus, frequently between two strictures. Foreign bodies in the esophagus produce defects of small sizes, as a rule, in the upper part of the esophagus, and numerous abrasions and hemorrhages in the mucous membrane. Wall ruptures under the influence of the hydraulic factor are of large sizes, observed in the thoracic or abdominal parts of the esophagus in patients with its pre-existing alterations. Perforating breaks in the esophagus wall favour early development of mediastinitis.
