Esophageal Perforation during Esophagoscopy in Children

Abstract

Traumatic perforation of the esophagus during esophagoscopy is an ever present danger that can have long lasting or lethal effects. All are agreed on the need for early diagnosis. The question is often asked whether treatment should be nonoperative or operative. The results of management in this series of 21 patients support the opinions of those who advocate early adequate drainage of the mediastinum by means of mediastinotomy or thoracotomy, with support by antibiotic therapy, nothing by mouth and careful observation, if a large perforation is present. In minor perforations conservative treatment alone may suffice but should be accompanied by alert clinical observation.