Abstract

GUZMAN TORO, Fernando; MORALES, Dimas  and  GUERRERO HERNANDEZ, Yusbelys A. Evaluación, diagnóstico y tratamiento de las perforaciones esofágicas: Estudio de 20 casos en el hospital universitario de maracaibo. Gen [online]. 2008, vol.62, n.3, pp.223-226. ISSN 0016-3503.

Esophageal perforation is a gastrointestinal affection with high morbidity and mortality. Between the most important causes of esophageal perforation we have: esophageal instrumental perforations, traumatic perforations, caustic agent ingestions, spontaneous esophagEAL perforations. In this paper we discuss the experience in the diagnosis and treatment of 20 patients with esophageal perforation in the Thoracic Surgery Service of the Hospital Universitario of Maracaibo in the years 1985 to the 2005. The average age of the patients was 26,30 + / - 19,97 years and the most frequent causes of esophageal perforation were: instrumental dilatation by stenosis in 6 patients, strange body perforation in 6 patients and traumatic perforation by gunshot wound in 3 patients. The most frequent symptoms were: disphagia, odinophagia, sialorrea and at physical examination: vesicular murmur decrease to auscultation in the respective hemithorax (35%). The surgical procedures more frequently developed included: total transthoracic esophagectomy in 7 patients, left cervicotomy with primary closure in 3 patients, toracotomy and primary closure of the perforation in 2 patients. 6 patients died (30%), 2 (10%) during the surgical procedure and 4 (20%) in the postoperatory period as a consequence of sepsis.

Keywords : perforation; esophagus; instruments; stenosis; disphagia.