Oster H, Wicke W, Wolner E
Wien Klin Wochenschr. 1978 Mar 31;90(7):218-21.
34 cases of perforation of the oesophagus are reported, partly treated at the surgical and partly at the E.N.T. department. Air emphysema of the throat or of the mediastinum and/or escape of the contrast medium was observed in all patients. The main cause of perforation was endoscopic examination. The patients partly underwent conservative and partly surgical therapy, both groups showing similar mortality rates. Small perforations in the upper third of the oesophagus can be treated conservatively, whereas perforations in the lower two thirds, especially with involvement of the pleura, pericardium or peritoneum, need rapid surgical intervention, as the prognosis improves in relationship to the rapidity with which treatment is instituted following perforation.