Esophageal Perforation

Esophageal perforation is full-thickness tear of esophagus (spontaneous Boerhaave, iatrogenic endoscopy, foreign body, trauma, malignancy), causing mediastinitis, fever, severe chest pain, and sepsis. Treatment: NPO; IV broad-spectrum antibiotics; IV fluids/nutrition (TPN/enteric distal feeding); immediate thoracic/ENT surgical or endoscopic repair/clipping/stent; drainage (chest tube/mediastinal); water-soluble contrast study/CT to localize; early repair best outcomes; ICU monitoring; treat underlying cause; long-term follow-up for stricture/fistula.

Common Symptoms

Severe chest pain; fever; subcutaneous emphysema; after endoscopy/vomiting/trauma

Causes and Pathogenesis

Full-thickness tear causes mediastinal contamination/mediastinitis/sepsis.

Treatment

NPO; IV antibiotics; drainage; surgical/endoscopic repair; nutrition; ICU

Preventive Measures

Careful endoscopy; avoid violent vomiting; treat foreign bodies early.

Department to Visit

It is recommended to visit the Thoracic-surgery/Gastroenterology/ENT/ICU/Emergency department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.