Esophageal Perforation in Children: A Review of one Pediatric Surgery Institution’s Experience (16 Years)

Abstract

Introduction: The objective of the study was to evaluate the experience of our service in the treatment of esophageal perforations. Materials and Methods: Retrospective chart review of the nine cases occurred between January 1, 1996 and December 31, 2011. Seven occurred after accidental ingestion of foreign bodies and in two patients were iatrogenic lesions after esophagoscopy with dilation: a peptic stricture in one case and in the other stenosis of the esophageal anastomosis in a child operated for esophageal atresia. Results: In 78% of cases the initial approach was medical, with healing of the perforation confirmed on average after 20 days, 22% of patients (2 cases) underwent surgery without success, one of them healed without sequelae having nothing by mouth and medical therapy, in the other case there was a need for further colon esophagoplasty. There was no mortality. Discussion: Esophageal perforation is one of the most serious injuries of the alimentary tract, continues to be devastating, and difficult to diagnosis and treatment. The recognition of this complication is critical for a successful treatment. Conclusions: The delay of the diagnosis is associated with a mortality which can oscillate between 20 and 40%.