Pettersson G, Larsson S, Gatzinsky P, Südow G
Scand J Thorac Cardiovasc Surg. 1981;15(3):321-4. doi: 10.3109/14017438109100596.
A series of 44 consecutive patients with oesophageal perforation treated during the ten-year period 1969-1978 has been reviewed. Thirty perforations were caused by oesophagoscopy using a rigid instrument, often combined with dilation and/or biopsy, 4 were caused by a fibreoptic instrument and 10 were spontaneous ruptures. A benign stricture was the most commonly associated lesion in the oesophagus. Six patients with an iatrogenic perforation were treated conservatively without mortality. These patients were characterized by mild symptoms, early recognition, minor leakage from the oesophagus and no communication to the pleural cavity. Fourteen patients were treated with closed thoracic drainage. The overall mortality among these patients was 70%, but for those with a spontaneous rupture it was 100%. Twenty-four patients were treated surgically with a mortality of 20%. Individualized treatment is recommended.
回顾了1969年至1978年这十年间连续收治的44例食管穿孔患者。30例穿孔由使用硬质器械的食管镜检查引起，常合并扩张和/或活检；4例由纤维光学器械引起；10例为自发性破裂。良性狭窄是食管中最常见的相关病变。6例医源性穿孔患者接受了保守治疗，无死亡病例。这些患者的特点是症状轻微、识别早、食管少量渗漏且未与胸腔相通。14例患者接受了胸腔闭式引流。这些患者的总体死亡率为70%，但自发性破裂患者的死亡率为100%。24例患者接受了手术治疗，死亡率为20%。建议进行个体化治疗。
