Perforations of the Esophagus and Stomach

What Should I Do?

Francesca Dimou, Vic Velanovich

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction: Esophageal and gastroduodenal perforations are relatively uncommon; however, they both can be potentially life-threatening. Esophageal perforations most commonly occur due to iatrogenic injury, forceful retching (Boerhaave’s syndrome), malignancy, foreign body ingestion, or caustic injury. Gastroduodenal perforations are most commonly due to peptic ulcer disease or malignancy. Pain and signs of sepsis are the most common presenting symptoms and signs.Methods: Determining the extent of critical illness and addressing hemodynamics and sepsis are the first priorities. Identifying the location and size of the perforation as well as extent of contamination is the next priorities. Although surgical intervention has been the mainstay of treatment, newer approaches have led to a heterogeneity of approaches.Conclusion: For esophageal perforation, observation, endoscopic, radiological, and surgical approaches may be appropriate. For gastroduodenal perforation, surgical approach is still the most appropriate, although a concomitant acid-reducing operation is usually not necessary. Despite these advances, mortality for both perforations can still be high. Sound judgment is necessary for optimal results.

Original languageEnglish (US)
Pages (from-to)400-406
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume19
Issue number2
DOIs
StatePublished - 2015
Externally publishedYes

Fingerprint

Esophageal Perforation
Esophagus
Stomach
Sepsis
Caustics
Wounds and Injuries
Foreign Bodies
Peptic Ulcer
Critical Illness
Signs and Symptoms
Neoplasms
Eating
Hemodynamics
Observation
Pain
Acids
Mortality
Therapeutics

Keywords

  • Duodenal perforation
  • Esophageal perforation
  • Gastric perforation

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Perforations of the Esophagus and Stomach : What Should I Do? / Dimou, Francesca; Velanovich, Vic.

In: Journal of Gastrointestinal Surgery, Vol. 19, No. 2, 2015, p. 400-406.

Research output: Contribution to journalArticle

Dimou, Francesca ; Velanovich, Vic. / Perforations of the Esophagus and Stomach : What Should I Do?. In: Journal of Gastrointestinal Surgery. 2015 ; Vol. 19, No. 2. pp. 400-406.
@article{61e3a16d9b374ae9933687e4fc1261f7,
title = "Perforations of the Esophagus and Stomach: What Should I Do?",
abstract = "Introduction: Esophageal and gastroduodenal perforations are relatively uncommon; however, they both can be potentially life-threatening. Esophageal perforations most commonly occur due to iatrogenic injury, forceful retching (Boerhaave’s syndrome), malignancy, foreign body ingestion, or caustic injury. Gastroduodenal perforations are most commonly due to peptic ulcer disease or malignancy. Pain and signs of sepsis are the most common presenting symptoms and signs.Methods: Determining the extent of critical illness and addressing hemodynamics and sepsis are the first priorities. Identifying the location and size of the perforation as well as extent of contamination is the next priorities. Although surgical intervention has been the mainstay of treatment, newer approaches have led to a heterogeneity of approaches.Conclusion: For esophageal perforation, observation, endoscopic, radiological, and surgical approaches may be appropriate. For gastroduodenal perforation, surgical approach is still the most appropriate, although a concomitant acid-reducing operation is usually not necessary. Despite these advances, mortality for both perforations can still be high. Sound judgment is necessary for optimal results.",
keywords = "Duodenal perforation, Esophageal perforation, Gastric perforation",
author = "Francesca Dimou and Vic Velanovich",
year = "2015",
doi = "10.1007/s11605-014-2702-2",
language = "English (US)",
volume = "19",
pages = "400--406",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
publisher = "Springer New York",
number = "2",

}

TY - JOUR

T1 - Perforations of the Esophagus and Stomach

T2 - What Should I Do?

AU - Dimou, Francesca

AU - Velanovich, Vic

PY - 2015

Y1 - 2015

N2 - Introduction: Esophageal and gastroduodenal perforations are relatively uncommon; however, they both can be potentially life-threatening. Esophageal perforations most commonly occur due to iatrogenic injury, forceful retching (Boerhaave’s syndrome), malignancy, foreign body ingestion, or caustic injury. Gastroduodenal perforations are most commonly due to peptic ulcer disease or malignancy. Pain and signs of sepsis are the most common presenting symptoms and signs.Methods: Determining the extent of critical illness and addressing hemodynamics and sepsis are the first priorities. Identifying the location and size of the perforation as well as extent of contamination is the next priorities. Although surgical intervention has been the mainstay of treatment, newer approaches have led to a heterogeneity of approaches.Conclusion: For esophageal perforation, observation, endoscopic, radiological, and surgical approaches may be appropriate. For gastroduodenal perforation, surgical approach is still the most appropriate, although a concomitant acid-reducing operation is usually not necessary. Despite these advances, mortality for both perforations can still be high. Sound judgment is necessary for optimal results.

AB - Introduction: Esophageal and gastroduodenal perforations are relatively uncommon; however, they both can be potentially life-threatening. Esophageal perforations most commonly occur due to iatrogenic injury, forceful retching (Boerhaave’s syndrome), malignancy, foreign body ingestion, or caustic injury. Gastroduodenal perforations are most commonly due to peptic ulcer disease or malignancy. Pain and signs of sepsis are the most common presenting symptoms and signs.Methods: Determining the extent of critical illness and addressing hemodynamics and sepsis are the first priorities. Identifying the location and size of the perforation as well as extent of contamination is the next priorities. Although surgical intervention has been the mainstay of treatment, newer approaches have led to a heterogeneity of approaches.Conclusion: For esophageal perforation, observation, endoscopic, radiological, and surgical approaches may be appropriate. For gastroduodenal perforation, surgical approach is still the most appropriate, although a concomitant acid-reducing operation is usually not necessary. Despite these advances, mortality for both perforations can still be high. Sound judgment is necessary for optimal results.

KW - Duodenal perforation

KW - Esophageal perforation

KW - Gastric perforation

UR - http://www.scopus.com/inward/record.url?scp=84925543468&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84925543468&partnerID=8YFLogxK

U2 - 10.1007/s11605-014-2702-2

DO - 10.1007/s11605-014-2702-2

M3 - Article

VL - 19

SP - 400

EP - 406

JO - Journal of Gastrointestinal Surgery

JF - Journal of Gastrointestinal Surgery

SN - 1091-255X

IS - 2

ER -