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Nonoperative Management of Contained Esophageal Perforation: Title and subTitle BreakTwo Case Reports FREE

Olaf S. Andersen, MD; Peter E. Giustra, MD
[+] Author Affiliations

Accepted for publication May 12, 1981.

Reprint requests to Penobscot Bay Medical Center, Glen Cove, Rockland, ME 04841 (Dr Andersen).


Arch Surg. 1981;116(9):1214-1217. doi:10.1001/archsurg.1981.01380210082017
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• Spontaneous perforation of the esophagus still carries a high rate of morbidity and mortality because of frequent delay in diagnosis, extensive mediastinal contamination, and inadequate surgical repair. We used a nonoperative approach in two patients in whom the perforation was well contained, with evidence of drainage back into the esophagus and few symptoms or signs of sepsis. Nonoperative management included administration of intravenous antibiotics and hyperalimentation. Both patients had a satisfactory outcome.

(Arch Surg 1981;116:1214-1217)

REFERENCES

Derbes VJ, Mitchell RE Jr:  Hermann Boerhaave's Atrocis, nec descripti prius, morbi historia, the first translation of the classic case report of rupture of the esophagus, with annotations . Bull Med Libr Assoc 1955;; 43:217-240.
Barrett NR:  Spontaneous perforation of the esophagus: Review of literature and report of three new cases . Thorax 1946;;1:48-70.
Barrett NR:  Report of a case of spontaneous perforation of the esophagus . Br J Surg 1947;;35:216-219.
Derbes VJ, Mitchell RE:  Rupture of the esophagus . Surgery 1956;; 39:688-709, 865-888.
Blichert-Toft M:  Spontaneous esophageal rupture. An evaluation of the results of treatment, 1944-1969 . Scand J Thorac Cardiovasc Surg 1971;;5:111-115.
Hardy JD, Thompkins WC, Ching EC, et al:  Esophageal perforation and fistulas . Ann Surg 1973;;1977:788-796.
Rosoff L, White EJ:  Perforation of the esophagus . Am J Surg 1974;; 128:207-218.
Skinner DB, Little A, DeMeester T:  Management of the esophageal perforation . Am J Surg 1980;;139:760-800.
Urschel HD, Razzuk MD, Wood RE, et al:  Improved management of the esophageal perforation: Exclusion and diversion in continuity . Ann Surg 1974;;179:587-600.
Brown RH, Cohen PS:  Nonsurgical management of spontaneous esophageal perforation . JAMA 1978;;240:140-142.
Larrieu AJ, Kieffer R:  Boerhaave syndrome: Report of a case treated nonoperatively . Ann Surg 1975;;181:452-454.
Sanderson RG:  Spontaneous rupture of the esophagus: Report of survival without surgical management . Am J Surg 1965;;109:506-508.
Cameron J, Kieffler R, Hendrix D, et al:  Selective nonoperative management of contained intrathoracic esophageal disruptions . Ann Thorac Surg 1979;;27:404-408.
Lyons W, Seremetis M, deGuzman V, et al:  Ruptures and perforations of the esophagus: The case of conservative supportive management . Ann Thorac Surg 1978;;25:346-350.

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Derbes VJ, Mitchell RE Jr:  Hermann Boerhaave's Atrocis, nec descripti prius, morbi historia, the first translation of the classic case report of rupture of the esophagus, with annotations . Bull Med Libr Assoc 1955;; 43:217-240.
Barrett NR:  Spontaneous perforation of the esophagus: Review of literature and report of three new cases . Thorax 1946;;1:48-70.
Barrett NR:  Report of a case of spontaneous perforation of the esophagus . Br J Surg 1947;;35:216-219.
Derbes VJ, Mitchell RE:  Rupture of the esophagus . Surgery 1956;; 39:688-709, 865-888.
Blichert-Toft M:  Spontaneous esophageal rupture. An evaluation of the results of treatment, 1944-1969 . Scand J Thorac Cardiovasc Surg 1971;;5:111-115.
Hardy JD, Thompkins WC, Ching EC, et al:  Esophageal perforation and fistulas . Ann Surg 1973;;1977:788-796.
Rosoff L, White EJ:  Perforation of the esophagus . Am J Surg 1974;; 128:207-218.
Skinner DB, Little A, DeMeester T:  Management of the esophageal perforation . Am J Surg 1980;;139:760-800.
Urschel HD, Razzuk MD, Wood RE, et al:  Improved management of the esophageal perforation: Exclusion and diversion in continuity . Ann Surg 1974;;179:587-600.
Brown RH, Cohen PS:  Nonsurgical management of spontaneous esophageal perforation . JAMA 1978;;240:140-142.
Larrieu AJ, Kieffer R:  Boerhaave syndrome: Report of a case treated nonoperatively . Ann Surg 1975;;181:452-454.
Sanderson RG:  Spontaneous rupture of the esophagus: Report of survival without surgical management . Am J Surg 1965;;109:506-508.
Cameron J, Kieffler R, Hendrix D, et al:  Selective nonoperative management of contained intrathoracic esophageal disruptions . Ann Thorac Surg 1979;;27:404-408.
Lyons W, Seremetis M, deGuzman V, et al:  Ruptures and perforations of the esophagus: The case of conservative supportive management . Ann Thorac Surg 1978;;25:346-350.

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