The Journal of Thoracic and Cardiovascular Surgery, Vol 74, 261-267, Copyright © 1977 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Pediatric esophageal perforation
RL Shepherd, JG Raffensperger and R Goldstein
Although esophageal perforation in children is associated with a spectrum
of disease different from the one in adults, management is essentially the
same for both groups. Over the past 11 years, 12 patients ranging in age
from 2 days to 10 years were treated for 13 perforations. Perforation in
the adult is associated with a high mortality rate. All children in this
series survived. Injury was secondary to instrumentation in 10 cases and
three resulted from the chronic erosion of a trapped foreign body. Of the
10 acute perforations, five occurred 12 days to 5 months after lye
ingestion. Anastomotic narrowing was a factor in three other cases. Seven
of the acute perforations involved the thoracic esophagus and were
associated with a high morbidity rate. Management consisted of operative as
well as nonoperative approaches. Consideration must be given to several
clinical variables including location, cause, predisposing factors,
underlying illnesses, associated injury, and promptness of medical
attention.
