식도천공에 대한 임상적 고찰 = Esophageal Perforation식도천공에 대한 임상적 고찰

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

Despite the support provided by adjuncts such as total parenteral nutrition, effective antibiotic. and hemodynamic monitoring, esophageal perforations continue to be associated with a mortality rate of more than 20%. In an effort to refine and improve treatment, we reviewed 6 cases of esophageal perforations from January, 1983 to August, 1992. The prevalent age group was 4th to 6th decades. The perforation site was cervical (2), thoracic (1) and distal (3). Clinical findings were fever, pain, dysphagia, and subcutaneous emphysema in cervical esophageal perforations compared with chest pain and epigastric pain in thoracic or distal esnphageal perforations. Causes of esophageal perforation were trauma, 2 cases, in cervical region and spontaneous rupture (Boerhaave syndrome), 4 cases in thoracic and distal region. Preoperatively, we performed simple neck and chest X-ray, esophagoscopy, fiberoptic gastroscopy (FGS) and esophagogram. Mortality was developed in 2 cases (33.3%p) and its causes were sepsis due to mediastinitis with delayed aclmission. In operative management, we recommed primary repair and drainage in cervical esophageal perforation. But in thoracic and distal esophageal perforation, the repair site should be butressed with viable serosal butress such as pleura and pericardium, if possible, to prevent subsequent leak at the suture line. 1n conclusion, early diagnosis and early operation is easential for patients with spill of contrast medium on esophagograms of clinical manifestations of esophageal soilage of the mediastinum or pleural cavities.