RT Journal
A1 BISGARD J, KERR H
T1 SUrgical management of instrumental perforation of the esophagus
JF Archives of Surgery
JO Archives of Surgery
YR 1949
FD June 1
VO 58
IS 6
SP 739
OP 751
DO 10.1001/archsurg.1949.01240030750002
UL http://dx.doi.org/10.1001/archsurg.1949.01240030750002
AB PERFORATION of the esophagus from instrumentation is a tragic accident and an urgent surgical emergency. Unless promptly and properly treated, it is usually fatal. Proper treatment consists of the immediate establishment of wide and free drainage to the site of perforation in addition to adequate antibiotic and supportive therapy and other less important measures. This has been emphasized by Hoover,1 Touroff2 and others.Although this discussion is concerned with perforation caused by instrumentation, it would seem desirable to include a classification of all causes.A. Instrinsic causes1. Tumors arising in the oesophagus2. Esophagitis Nonspecific, tuberculous, syphilitic3. Spontaneous perforations Ruptures from violent vomiting4. Ulceration Peptic, Curling's (Rankin)3B. Extrinsic causes1. Instrumentation Endoscopy, dilation2. Swallowed foreign bodies Bones, dentures, pins3. Penetrating wounds Stab, bullet4. Penetration of extrinsic neoplasms5. Perforations of extrinsic infections Pyogenic and tuberculous adenitis and mediastinal abscesses6.